| NPI | 1750528659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY BROOKES BANKS Owner 618-670-8982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MO 2008029830) |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-02-20 |