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General NPI Number Information
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NPI Number | 1487900684
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Entity Type | Organization
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Legal Business Name | ST. LOUIS BONE AND JOINT CENTER, LLC
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 08/20/2012
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Provider Practice Location Address
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Address Line | 8000 GRAVOIS RD
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City | SAINT LOUIS
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State | MO
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Zip | 63123-4721
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Country | US
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Telephone | 314-351-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 8000 GRAVOIS RD
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City | SAINT LOUIS
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State | MO
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Zip | 63123-4721
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Country | US
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Telephone | 314-351-2500
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC WILLIAM WERNER
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Credential | DC, MPH
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Telephone | 314-351-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 2012023237
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License Number State | MO
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