| NPI | 1548484819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMEY DRAKE Admin Manager 314-983-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 000603) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: MO 2010024583) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 2012010878) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2022-06-27 |