Organization
PLASTIC AND RECONSTRUCTIVE SURGERY OF MID-MISSOURI, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD ROYER (ADMINISTRATOR)
(573) 777-1191
Entity
Organization
Contact information
Practice address
1701 E BROADWAY, SUITE 304, COLUMBIA, MO 65201-8018
(573) 876-1700
(573) 876-1705
Mailing address
1701 E BROADWAY, SUITE 304, COLUMBIA, MO 65201-8018
(573) 876-1700
(573) 876-1705
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
R5577
MO
Other
Enumeration date
04/28/2010
Last updated
04/28/2010
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