| NPI | 1174830640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY EGHIGIAN Director Credentialing 314-935-0770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MO 091104) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2010-09-07 |