| NPI | 1992461776 |
|---|---|
| Other Name | ICAN CLINIC MO PC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL HARBISON Owner 618-254-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2021-11-16 |