| NPI | 1750563722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L. JOHNSON CEO 573-438-8321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2013-06-11 |