| NPI | 1184900516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PATRICK BERRY Director Of Sports Medicine 314-598-1663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2011-10-31 |