| NPI | 1811752900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE WOLFE Owner 314-396-9517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| 261QP1100X Clinic/Center, Podiatric | |
| Enumeration Date | 2024-02-16 |
| Last Update Date | 2025-01-31 |