| NPI | 1093120883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA ANN WILLIAMSON Owner 314-699-0919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MO 2012009252) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2014-07-01 |