| NPI | 1134530173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE PETER BEE CEO/Owner 618-625-2105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036125672) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: IL 036125672) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: IL 036125672) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036125672) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: IL 036125672) | |
| 291U00000X Clinical Medical Laboratory (Licence: IL 14D2034829) | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-05-13 |