Provider First Line Business Practice Location Address:
100 MEDICAL PLAZA DR
Provider Second Line Business Practice Location Address:
EMERGENCY DEPARTMENT
Provider Business Practice Location Address City Name:
LAKE SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-625-5300
Provider Business Practice Location Address Fax Number:
636-625-5376
Provider Enumeration Date:
04/03/2012