| NPI | 1235571134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J MILNE Owner 314-991-9922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2003014166) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2016-05-20 |