| NPI | 1417459207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES SNIDER VP Physician Network 636-685-7804 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2021-04-06 |