| NPI | 1295452969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALORIE ANNE HARRIS Manager/Owner 314-265-7542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZA2600X Specialist/Technologist, Other, Art, Medical |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2022-12-05 |