| NPI | 1104059641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S BUTLER Member 636-346-9430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: 768) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 004747) |
| 207R00000X Internal Medicine (Licence: MO R4647) | |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2014-02-06 |