| NPI | 1558487009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER HARTSHORN Authorized Official 314-800-2017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MO 121-7) |
| Additional Taxonomies | 261QE0800X Clinic/Center, Endoscopy (Licence: MO 121-2) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2022-08-12 |