| NPI | 1962459768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN J. TUCKER President 573-893-6279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2002014089) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2020-08-22 |