| NPI | 1871817726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS ANTHONY HASENFRATZ Owner 636-357-1769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MO 2009025726) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2010-03-22 |