Provider First Line Business Practice Location Address:
VA MEDICAL CENTER - JEFFERSON BARRACKS
Provider Second Line Business Practice Location Address:
BLDG 1, RM 1E18
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-652-4100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/23/2007