| NPI | 1053341289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH HALL Administrator 636-939-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-03-05 |