| NPI | 1922588821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT G. FOWERS Medical Doctor 573-774-4992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MO 2015013466) |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2018-08-20 |