| NPI | 1194765685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY L EGHIGIAN Sr Director, Managed Care 314-273-0770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2022-07-18 |