Provider First Line Business Practice Location Address:
2920 FEE FEE ROAD
Provider Second Line Business Practice Location Address:
NNC NATIONAL HEALTHCARE MARYLAND HEIGHTS
Provider Business Practice Location Address City Name:
ST LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-291-0121
Provider Business Practice Location Address Fax Number:
314-291-0132
Provider Enumeration Date:
12/05/2006