| NPI | 1952804668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS R PUTTHOFF Office Administrator 417-830-1409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QH0700X Clinic/Center, Hearing and Speech | |
| 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2018-03-09 |