| NPI | 1922144344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK K. JOHNSON Owner And Solo Pracitioner 417-256-6536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center Podiatric (Licence: MO 000553) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2011-01-04 |