| NPI | 1891090395 |
|---|---|
| Doing Business As | CARDINAL PHYSICAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | RICHARD WAYNE BLALOCK Member/Manager 636-352-0380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MO 2011000744) |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2017-03-01 |