| NPI | 1912616194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLEY PAGE Director 417-861-9739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2022-11-16 |
| Last Update Date | 2025-06-24 |