| NPI | 1003110792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES P. EMMANUEL Board Member 314-997-1777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: MO 110-9) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2020-05-20 |