| NPI | 1710416755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM SHOMSTEIN Owner 314-516-3289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2017-06-04 |
| Last Update Date | 2017-06-04 |