| NPI | 1780948018 |
|---|---|
| Doing Business As | SLUCARE DEPT OF F&CM SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | ALYCE LANXON Executive Director 314-977-6828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2021-09-21 |