| NPI | 1437336013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE MYRON THOMPSON Owner 314-368-3329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IA 06631) |
| Enumeration Date | 2008-01-26 |
| Last Update Date | 2012-02-09 |