| NPI | 1750590295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEARLETHA ROZENIA WASHINGTON Owner 636-357-7667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO MD 108476) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |