| NPI | 1831219377 |
|---|---|
| Doing Business As | FUNDAMENTAL HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | LAWRENCE P. TYLER Owner/Provider 636-239-2323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MO 4945) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2010-06-01 |