| NPI | 1841234150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER HARTSHORN Officer / Authorized Official 314-800-2017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 7002314) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-12-01 |