NPI | 1336547199 |
---|---|
Former Legal Business Name | NONE |
Entity Type | Organization |
Authorized Contact | JOHN BARLOW MARTIN Physician 314-725-2618 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care (Licence: MO 26157) |
Enumeration Date | 2014-12-10 |
Last Update Date | 2014-12-10 |