| NPI | 1194820860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LAWRENCE PITTENGER Controling Owner 636-938-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO D030648) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2002004657) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2010-02-04 |