| NPI | 1073069522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES H TADROS Physician/Owner 314-270-4247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MO R7P58) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2018-11-13 |