| NPI | 1275665390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN ALLEN ANDREWS Owner 636-561-2229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO R6E67) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |