| NPI | 1376702738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADONNA TERESSA FINCH Proprietor 314-645-7265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 115448) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2011-11-03 |