| NPI | 1639679749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY EGHIGIAN Senior Director Managed Care 314-273-0770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2025-04-25 |