Slucare Dept Of Fcm Sports Medicine | |
1225 South Grand 2l, Door 5 St Louis MO 63104-6310 | |
(314) 977-4440 | |
Not Available |
Full Name | Slucare Dept Of Fcm Sports Medicine |
---|---|
Speciality | Family Medicine - Sports Medicine |
Location | 1225 South Grand, St Louis, Missouri |
Authorized Official Name and Position | Alyce Lanxon (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 3149776828 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Slucare Dept Of Fcm Sports Medicine 3545 Lindell Blvd Fl 3 Saint Louis MO 63103-1020 Ph: (314) 977-6828 | Slucare Dept Of Fcm Sports Medicine 1225 South Grand 2l, Door 5 St Louis MO 63104-6310 Ph: (314) 977-4440 |
NPI Number | 1306120183 |
---|---|
Provider Enumeration Date | 09/28/2011 |
Last Update Date | 09/21/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306120183 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
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