Provider First Line Business Practice Location Address:
CID BLDG WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Provider Second Line Business Practice Location Address:
DEPT OF PSYCHIATRY
Provider Business Practice Location Address City Name:
ST LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-286-2282
Provider Business Practice Location Address Fax Number:
314-286-2285
Provider Enumeration Date:
05/27/2008