| NPI | 1982682597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES W CUNNINGHAM Owner 573-729-5533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 121934) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 33540) |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2025-09-11 |