| NPI | 1336368034 |
|---|---|
| Doing Business As | SLUCARE DEPT OF PEDIATRIC SPORT MEDICINE |
| Entity Type | Organization |
| Authorized Contact | ALYCE LANXON Executive Director 314-977-6828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2021-09-21 |