Provider First Line Business Practice Location Address:
3023 N BALLAS RD
Provider Second Line Business Practice Location Address:
SUITE 500D RHEUMATOLOGY & INTERNAL MED ASSOC OF WEST CO
Provider Business Practice Location Address City Name:
ST LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-567-4541
Provider Business Practice Location Address Fax Number:
314-569-3647
Provider Enumeration Date:
08/09/2007