Healthcare Provider Details
I. General information
NPI: 1326191537
Provider Name (Legal Business Name): ALLERGY ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1570 WOODLAKE DR
CHESTERFIELD MO
63017-5712
US
IV. Provider business mailing address
1570 WOODLAKE DR
CHESTERFIELD MO
63017-5712
US
V. Phone/Fax
- Phone: 314-878-0996
- Fax: 314-878-0683
- Phone: 314-878-0996
- Fax: 314-878-0683
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | MDR9374 |
| License Number State | MO |
VIII. Authorized Official
Name: DR.
RAND
E
DANKNER
Title or Position: OWNER
Credential: M.D.
Phone: 314-878-0996