Provider First Line Business Practice Location Address:
CENTER FOR SPECIALIZED MEDICINE
Provider Second Line Business Practice Location Address:
1221 S. GRAND BLVD, 2ND FLOOR
Provider Business Practice Location Address City Name:
ST LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-977-6055
Provider Business Practice Location Address Fax Number:
314-977-3370
Provider Enumeration Date:
08/04/2006