| NPI | 1205049079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN M JACOBS Owner 314-367-6545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MO 000436) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2013-01-17 |