Provider First Line Business Practice Location Address:
7840 NATURAL BRIDGE RD
Provider Second Line Business Practice Location Address:
PATIENT CARE CENTER
Provider Business Practice Location Address City Name:
ST LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-516-5131
Provider Business Practice Location Address Fax Number:
314-516-6405
Provider Enumeration Date:
10/05/2020