| NPI | 1831269695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA LEE WILSON Insurance And Billing Specialist 573-815-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-08-22 |