| NPI | 1922144484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABRINA DYDELL Administrator 636-728-1977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MO R3N29) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2023-08-31 |