NPI | 1225548290 |
---|---|
Entity Type | Organization |
Authorized Contact | NICHOLAS J DIVAN Chiropractor 314-961-7181 |
Organization Subpart ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MO 2014010441) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: MO 2014010441) |
Enumeration Date | 2017-10-04 |
Last Update Date | 2017-10-04 |