| NPI | 1962707075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES C MAULDIN Owner 417-848-2161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MO R6J28) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2011-01-20 |