| NPI | 1063741767 |
|---|---|
| Doing Business As | BODYLOGICMD OF ST. LOUIS |
| Entity Type | Organization |
| Authorized Contact | BRYAN WARNER Director 877-445-9050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MO 2009032163) |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2009-12-09 |