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 |