I was called once by this number, and they left two voice mails. It was automated and asked if I would like to confirm or cancel my appointment. The caller id said it was from MO, USA.
This number is an automated call from Ralston Veterinary Clinic in Ralston, Nebraska calling to remind me of my dogs vet appointment. Not a sales call, not a scammer. Not sure why it has a MO, USA number but that's what it was.