NPI | 1992884217 |
---|---|
Entity Type | Organization |
Authorized Contact | BROOKS M TRAVIS Owner 573-443-0551 |
Organization Subpart ? | No |
Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MO R8620) |
Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MO 2002023835) |
Enumeration Date | 2006-11-06 |
Last Update Date | 2009-08-17 |