Healthcare Provider Details

I. General information

NPI: 1093117335
Provider Name (Legal Business Name): TRUE HEALTH INTEGRATION AND SYNERGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2014
Last Update Date: 09/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6311 RONALD REAGAN DR #167
LAKE ST LOUIS MO
63367-2681
US

IV. Provider business mailing address

6311 RONALD REAGAN DR #167
LAKE ST LOUIS MO
63367-2681
US

V. Phone/Fax

Practice location:
  • Phone: 314-735-5197
  • Fax: 314-338-3495
Mailing address:
  • Phone: 314-735-5197
  • Fax: 314-338-3495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2012040658
License Number StateMO

VIII. Authorized Official

Name: DR. JAMES D SILLS-POWELL
Title or Position: PRESIDENT
Credential: DPM
Phone: 314-735-5197