| NPI | 1962435107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J GORMAN Owner 636-728-1777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MO 103326) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-08-22 |