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 |