| NPI | 1922280189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY A HAAS Office Manager 573-686-5564 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MO R3284) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO R3284) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 143295) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 089729) | |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2007-11-29 |