Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2007-03-23
- Last updated
- 2020-08-22
Specialties
Licenses
- License MO
- 031519
Location
- Practice location
- 3 SW 1ST LN
- City
- LAMAR MO
- Postal code
- 647591772
- Phone
- 417-682-6184
Organization contact
- Name
- SAM CROSBY
- Title
- Owner
- Phone
- 4176826184
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.