| NPI | 1972522142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE LYNN MATTLI Clinical Manager 636-300-4036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-08-22 |