| NPI | 1669269635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN FLICK Owner 618-977-3608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2025-04-23 |
| Last Update Date | 2025-07-29 |