| NPI | 1811368244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRENCE ERIC CHAVIS Owner 314-551-0338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2026-08-17 |