Sps Practice Group, LLC

NPI #1053046888 in Columbia, Missouri

Provider Information

NPI Number: 1053046888
Entity Type: Organization
Organization Name: Sps Practice Group, LLC
Primary Specialty: Plastic Surgery
Enumeration Date: Jul 17, 2022
Last Updated: Aug 15, 2023

Practice Location

Address: 3220 BLUFF CREEK DR
City: Columbia
State: Missouri
ZIP Code: 65201-3663
Phone: (573) 690-6129

Authorized Official

Name: DR. LESLIE SHOCK, MD
Title: OWNER
Phone: (573) 224-8200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Plastic Surgery	208200000X	Primary

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