| NPI | 1164860375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAISY YOUNG Nurse Practitioner 314-494-2584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: MO 2002031370) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2013-10-29 |