NPI | 1215112040 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHARD A KOELLING President 636-477-6100 |
Organization Subpart ? | No |
Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: MO 005857) |
Additional Taxonomies | 111NS0005X Chiropractor Sports Physician (Licence: MO 006014) |
Enumeration Date | 2007-12-28 |
Last Update Date | 2014-10-15 |