| NPI | 1477615284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER HARTSHORN Officer/Authorized Official 314-800-2017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QE0800X Clinic/Center, Endoscopy (Licence: CO 1604XC) |
| 261QE0800X Clinic/Center, Endoscopy (Licence: CO 16R178) | |
| 261QE0800X Clinic/Center, Endoscopy (Licence: CO 1604F6) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2024-10-11 |