| NPI | 1154626448 |
|---|---|
| Other Name | SPECIALTY CLINIC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL HAYES Business Office Manager 618-443-2177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2018-08-21 |