| NPI | 1861826307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA BLOOM Manager/Owner 417-434-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: OK 26032) |
| Enumeration Date | 2013-09-01 |
| Last Update Date | 2013-09-01 |