| NPI | 1043879471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE L ADEAMS Practice Administrator 636-577-7812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2019-06-10 |