| NPI | 1841475803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY LYLE GALLAGHER Manager/Member 417-283-1845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OR MD21961) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2020-01-02 |