| NPI | 1770149304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID C PRATHER Chief Financial Officer 573-331-5129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2019-05-20 |