| NPI | 1114120649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND JAMES OTTOMEYER Owner 636-379-5934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MO 112431) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 111N00000X Chiropractor | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2022-02-24 |