NPI | 1407673965 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID CHURCH VP Of Finance 618-972-5228 |
Organization Subpart ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
Enumeration Date | 2024-09-25 |
Last Update Date | 2024-09-25 |