| NPI | 1730698374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL SCOVILLE Nurse Administrator 314-842-2607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2019-07-19 |