NPI 1053046888

Sps Practice Group, LLC

Organisation Plastic Surgery Physician Columbia, MO

Practice location

Address: 3220 Bluff Creek Dr, Columbia, MO 65201-3663
Phone: (573) 690-6129
Mailing address: 3220 Bluff Creek Dr STE 107, Columbia, MO 65201-3664

Authorised official

Name: Leslie Shock
Title: Owner
Phone: (573) 224-8200

Registered specialties

Plastic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208200000X

Other Plastic Surgery providers in Missouri →

Registry record

NPI: 1053046888
Entity type: Organization
NPI issued: 17 Jul 2022
Record last updated: 15 Aug 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.