| NPI | 1487620043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER HARTSHORN Officer/Authorized Official 314-800-2017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: OH 0633AS) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2020-07-15 |