Provider First Line Business Practice Location Address:
3015 N. BALLAS ROAD
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PATHOLOGY
Provider Business Practice Location Address City Name:
ST. LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63131-2329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-581-6523
Provider Business Practice Location Address Fax Number:
630-472-9502
Provider Enumeration Date:
02/23/2006