| NPI | 1114926714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER HARTSHORN Officer/Authorized Official 314-800-2017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: OH 1151AS) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2023-06-07 |