| NPI | 1508096306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE GENEVIEVE SHANNON Owner 314-495-8718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation (Licence: MO 2006028602) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2009-07-15 |