| NPI | 1902034218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES TRAVIS BRAWNER Sole Member Of LLC 417-230-7874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 2009001424) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2019-12-03 |