| NPI | 1073184248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW MORNINGSTAR Owner 636-244-0124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2021-07-08 |