| NPI | 1407068851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOULE N STEVENSON Physician Owner 314-731-7844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MO 2002019263) |
| Enumeration Date | 2007-05-05 |
| Last Update Date | 2011-05-02 |