Provider First Line Business Practice Location Address:
DEPT OF MEDICINE UNIV OF MISSOURI
Provider Second Line Business Practice Location Address:
ONE HOSPITAL DRIVE NE402
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65212-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-882-8857
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/18/2011