| NPI | 1659631398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER JAMES ANDERSON Owner 314-956-9187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016.005443) |
| Enumeration Date | 2012-05-28 |
| Last Update Date | 2020-04-27 |