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General NPI Number Information
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NPI Number | 1467695999
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC URGENT CARE OF AMERICA LLC
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 04/14/2009
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Provider Practice Location Address
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Address Line | 12152 TESSON FERRY RD
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City | SAINT LOUIS
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State | MO
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Zip | 63128-1726
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Country | US
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Telephone | 314-724-6064
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Fax | 314-849-2042
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Provider Business Mailing Address
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Address Line | 10842 KENNERLY RD
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2031
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Country | US
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Telephone | 314-724-6064
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | KEITH A CAMPBELL
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Credential | MBA
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Telephone | 314-724-6064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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