| NPI | 1841737798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP KINTNER Owner 573-664-1278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO 2011017279) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2017-01-30 |