Provider First Line Business Practice Location Address:
UNIVERSITY OF MISSOURI SCHOOL OF MEDICINE,
Provider Second Line Business Practice Location Address:
DEPT OF CHILD HEALTH. 1 HOSPITAL DRIVE
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-882-3996
Provider Business Practice Location Address Fax Number:
573-884-4277
Provider Enumeration Date:
03/24/2006