| NPI | 1841261153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSIE CALL Credentialing 573-556-1783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology (Licence: MO 0980220) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: MO 26D0446044) |
| 333600000X Pharmacy (Licence: MO 006386) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2023-10-30 |