| NPI | 1144339334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYD CHARISSE WILLIAMS Owner/Physician 314-647-4880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MO 1999135803) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |