| NPI | 1770715906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | H. KENNETH GILBERTSON Owner 314-739-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 003647) |
| 247200000X Technician, Other | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2013-02-25 |