| NPI | 1326845124 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KATINA SMITH Advanced Practice Nurse 314-922-5512  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services | 
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care | 
| Enumeration Date | 2025-02-27 | 
| Last Update Date | 2025-02-27 |