| NPI | 1982426268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE SCHMIDT Executive Director 573-884-1753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine |
| Enumeration Date | 2024-10-29 |
| Last Update Date | 2024-10-29 |