| NPI | 1942881834 |
|---|---|
| Doing Business As | PEMISCOT SPECIALTY CLINIC |
| Entity Type | Organization |
| Authorized Contact | JOAN WHITE-WAGONER CEO 573-359-3612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2023-10-03 |