| NPI | 1720095466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY JEAN DEIMUND Office Manager 573-335-4448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO R8494) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO MD108690) |
| 207Y00000X Otolaryngology (Licence: MO 2001021769) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2020-08-22 |