| NPI | 1902098049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA L MCINTIRE Manager 417-623-6767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MO R5N23) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-08-13 |