NPI | 1811268428 |
---|---|
Entity Type | Organization |
Authorized Contact | JOSEPH MICHAEL SERIA Physician 314-647-2777 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO 31739) |
Enumeration Date | 2012-01-13 |
Last Update Date | 2012-01-13 |