| NPI | 1396792412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DAVIS President Orthopedic Surgeon 618-997-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 042617215) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 261QP1100X Clinic/Center, Podiatric | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 042617215) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2022-10-04 |