Type 2 organization · NPI 1023229804
STATE OF MISSOURI
251B00000X · FULTON, MO
Why this profile is appearing now
Observed change signals
No current public change signal is attached to this profile.
Reported classification
Taxonomies
| Code | Description | Source flag |
|---|---|---|
| 251B00000X | 251B00000X | Primary |
Taxonomy reporting does not establish licensure, board certification, expertise, or quality.
Longitudinal record
Observed change timeline
- 0 recorded field change s