Provider First Line Business Practice Location Address:
UNIVERSITY HOSPITAL 1 HOSPITAL DR DC 043.00
Provider Second Line Business Practice Location Address:
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:
573-884-1606
Provider Business Practice Location Address Fax Number:
573-884-4533
Provider Enumeration Date:
06/16/2022