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1861446445
TAMARA R MIRACLE
COLUMBIA, MO
NPI
1861446445
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MO 2003011632)
Enumeration Date
2006-05-19
Last Update Date
2019-08-28
Business Address
TAMARA R MIRACLE PA
1 HOSPITAL DR
COLUMBIA, MO 65212-0001
Phone number: 573-884-4400
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Mailing Address
TAMARA R MIRACLE PA
PO BOX 843966
KANSAS CITY, MO 64184-3966
Phone number: 573-884-3300
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