| NPI | 1033987029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON RHODES Owner 314-983-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2024-05-22 |