| NPI | 1962609446 |
|---|---|
| Doing Business As | SJC-FAMILY MEDICINE-SOUTH CREEK |
| Entity Type | Organization |
| Authorized Contact | DONN E. SORENSEN Senior Vice President 417-829-4264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2008-06-30 |