Provider First Line Business Practice Location Address:
10016 KENNERLY RD
Provider Second Line Business Practice Location Address:
ST ANTHONY'S MEDICAL CENTER, HYLAND BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
ST LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-525-1400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/16/2009