| NPI | 1730142415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA SUE HUFFMAN VP Managed Care Services 636-549-2384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: MD A1383) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2020-08-22 |