| NPI | 1912249939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A PETRO Office Manager 417-621-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MO R2A49) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2014-03-04 |