| NPI | 1063603140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FALLWELL Owner/President 314-434-2886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QX0100X Clinic/Center, Occupational Medicine |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-08-05 |