| NPI | 1760771869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT STEVEN SUTTERER Owner 636-272-0008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2002015981) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2011-12-30 |