Provider First Line Business Practice Location Address:
800 HOSPITAL DR
Provider Second Line Business Practice Location Address:
HARRY S TRUMAN MEM.VETERANSHOSPITAL
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
157-381-4635
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2005