| NPI | 1568424950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDY MARIE GAROFALO Administrator 636-239-1766 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2010-06-04 |