| NPI | 1790439842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE MCCLANAHAN Owner 417-735-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2022-08-25 |