| NPI | 1265055818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY HELLING Authorized Representative 314-378-5422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2020-05-18 |