Healthcare Provider Details

I. General information

NPI: 1144430612
Provider Name (Legal Business Name): CHRISTINA A. GARRETTO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA A. SLOWIK

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12348 OLD TESSON RD
ST. LOUIS MO
63128
US

IV. Provider business mailing address

PO BOX 502852
SAINT LOUIS MO
63150-0001
US

V. Phone/Fax

Practice location:
  • Phone: 314-272-2014
  • Fax: 314-272-2170
Mailing address:
  • Phone: 314-364-4990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2006018417
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: