| NPI | 1962748285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL KATTUPALLI Owner/Physician 417-353-9069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: PA MD440359) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2013-04-02 |