NPI | 1780707406 |
---|---|
Doing Business As | SJC-MOUNTAIN GROVE |
Entity Type | Organization |
Authorized Contact | DONN E. SORENSEN Senior Vice President 417-829-4264 |
Organization Subpart ? | No |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2007-04-09 |
Last Update Date | 2008-06-30 |