| NPI | 1205856119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S KORENFELD President 636-390-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO R1P88) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2022-09-28 |