| NPI | 1891200895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATSY ANN LEECH Owner 314-485-5845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2017-12-12 |