| NPI | 1649503772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | URSULA W MARSH Owner 636-357-0136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health (Licence: MO 2007036957) |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2015-05-18 |