| NPI | 1780839928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN M SIMMONS Owner 636-239-5556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: MO 6090) |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2008-12-01 |