| NPI | 1952878795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY WALSMA Owner 314-620-8573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 207X00000X Orthopaedic Surgery | |
| 208200000X Plastic Surgery | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2024-04-18 |