| NPI | 1710529656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLEY PAGE Director 417-861-9739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2025-06-25 |