| NPI | 1538384300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY MARIA REED Owner 314-381-2224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: MO 000797) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2008-11-10 |