| NPI | 1386498319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARIA SACCOCIO Owner 314-209-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2024-04-16 |
| Last Update Date | 2026-06-02 |