| NPI | 1861782864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE LYNN CARDA Owner 573-776-7393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO Md111753) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO Md111753) |
| 208800000X Urology (Licence: MO MD111753) | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2011-04-11 |