Provider First Line Business Practice Location Address:
10010 KENNERLY RD
Provider Second Line Business Practice Location Address:
ST ANTHONYS HOSPITAL
Provider Business Practice Location Address City Name:
ST LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63128-1659
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-895-3828
Provider Business Practice Location Address Fax Number:
314-985-3827
Provider Enumeration Date:
10/10/2005