| NPI | 1033357314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE MATHISON Office Manager 636-928-4447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MO 000758) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MO 000806) |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2009-01-26 |