Provider First Line Business Practice Location Address:
18997 HIGHWAY C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARNETT
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65011-3031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-539-2515
Provider Business Practice Location Address Fax Number:
573-539-2516
Provider Enumeration Date:
04/01/2026