Organization
MIDWEST SINUS ALLERGY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LINDSAY KETCHUM (OFFICE MANAGER)
(573) 815-0662
Entity
Organization
Contact information
Practice address
3315 BERRYWOOD DR, STE. 207, COLUMBIA, MO 65201-6571
(573) 815-0662
Mailing address
3315 BERRYWOOD DR, STE. 207, COLUMBIA, MO 65201-6571
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36516
MO
Other
Enumeration date
03/23/2015
Last updated
03/23/2015
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