| NPI | 1760939060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES B DAVIS Executive Director 618-257-4644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036125732) |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2016-09-02 |