NPI | 1972057990 |
---|---|
Entity Type | Organization |
Authorized Contact | MARLEY PAGE Director 417-861-9739 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
Additional Taxonomies | 207Q00000X Family Medicine |
207R00000X Internal Medicine | |
207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism | |
208000000X Pediatrics | |
Enumeration Date | 2016-08-08 |
Last Update Date | 2025-06-24 |