| NPI | 1164763074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY ANN SPIESS Phn Supervisor 314-679-7877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: MO 2009006104) |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2013-03-04 |