NPI | 1801172903 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID A BRAASCH President 618-463-7301 |
Organization Subpart ? | Yes |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: IL 2009455) |
Enumeration Date | 2011-11-02 |
Last Update Date | 2021-03-22 |