NPI | 1285358481 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL BOEDEFELD Owner/Medical Director 636-706-0560 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2022-09-30 |
Last Update Date | 2024-04-11 |