| NPI | 1689655631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRY C EGGLESTON Owner 314-872-7744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MO 159-0) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2007-09-05 |