| NPI | 1447494133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICK FALCONER Medical Director 314-692-2639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MO 115456) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2009-04-24 |