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Individual

JANET MIEDEMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1600 E BROADWAY, COLUMBIA, MO 65201-5844
(573) 815-8000
Mailing address
709 WEST BLVD S, COLUMBIA, MO 65203-2758

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2005038795
MO

Other

Enumeration date
08/29/2007
Last updated
08/29/2007
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