| NPI | 1740396035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY WADLEY Office Manager 573-635-7651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO R4N29) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO R8638) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2010-02-03 |