| NPI | 1649555087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ANTHONY MCCLARY Sole Member 314-249-5252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MO 2004028080) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2011-10-17 |