| NPI | 1487807483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS GREGORY COLBERT Owner/Physician 314-383-5221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: MO R8H27) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2008-11-04 |