| NPI | 1255723060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L POWELL Administrator 636-734-0386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: MO 2007003269) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2015-03-03 |