| NPI | 1851968770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN DAVISON CFO 573-331-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2021-06-09 |