| NPI | 1962740589 |
|---|---|
| Doing Business As | ADVANCED WEIGHT LOSS CLINIC |
| Entity Type | Organization |
| Authorized Contact | SARA LEE ANN CASSIDY Manager 573-336-8746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-01-17 |