| NPI | 1184908865 |
|---|---|
| Doing Business As | SLUCARE DEPT OF PEDIATRIC UROLOGY |
| Entity Type | Organization |
| Authorized Contact | ALYCE LANXON Executive Director 314-977-6828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2088P0231X |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2021-09-21 |