| NPI | 1710066014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LADEVICH CEO 314-842-8655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MO 129-2) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2008-04-14 |