| NPI | 1770599581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERIANNE BLISS Chief Physician 660-543-4770 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-12-10 |