| NPI | 1326335019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM P KIDD Business Manager 636-229-4239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology (Licence: MO LC1142668) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2011-07-01 |