| NPI | 1881159523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLEY PAGE Director 417-861-9739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2025-06-25 |