| NPI | 1700298726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYSSA VISCONTI Practice Manager 314-322-9254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2014-05-26 |
| Last Update Date | 2014-05-26 |