| NPI | 1710231642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER HARTSHORN Officer/Authorized Official 314-803-0330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2024-09-17 |