| NPI | 1184594079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MOON Director 636-226-5132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology |
| Enumeration Date | 2025-11-06 |
| Last Update Date | 2025-11-06 |