Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2007-02-09
- Last updated
- 2020-08-22
Specialties
Licenses
- License MO
- 033701
Location
- Practice location
- 214 HARTMAN PL, SUITE 100
- City
- SAINT CLAIR MO
- Postal code
- 630772464
- Phone
- 636-629-6161
Organization contact
- Name
- JACKIE HARTMAN
- Title
- Administrator Owner
- Phone
- 6366296161
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.