| NPI | 1043842735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL CROOKS Owner 314-619-4596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-02-10 |