| NPI | 1114253093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER HARTSHORN Authorized Official 314-800-2017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2025-01-10 |