NPI | 1912016916 |
---|---|
Entity Type | Organization |
Authorized Contact | LINDA L RODDEN Owner 636-946-2244 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
Additional Taxonomies | 111N00000X Chiropractor |
225100000X Physical Therapist | |
261QR0400X Clinic/Center, Rehabilitation (Licence: MO 26627) | |
Enumeration Date | 2006-08-30 |
Last Update Date | 2021-08-26 |