| NPI | 1831160480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL M SPEZIA Medical Director 636-928-1670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MO 100-6) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2020-08-22 |