| NPI | 1487873030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER RODGERS Manager 636-379-9633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2011-08-15 |