| NPI | 1730359340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY TALTON Clinic Manager 660-627-2553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: MO 19139861) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2013-10-01 |