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General NPI Number Information
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NPI Number | 1528833068
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Entity Type | Organization
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Legal Business Name | NOUR MEDICAL SPA
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Dates
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Enumeration Date | 11/15/2023
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Last Update Date | 06/21/2025
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Provider Practice Location Address
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Address Line | 957 BURGUNDY LN
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City | MANCHESTER
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State | MO
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Zip | 63011-3585
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Country | US
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Telephone | 314-287-8447
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Fax | 877-455-4214
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Provider Business Mailing Address
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Address Line | 957 BURGUNDY LN
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City | MANCHESTER
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State | MO
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Zip | 63011-3585
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Country | US
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Telephone | 314-287-8447
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Fax |
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Authorized Official
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Title or Position | OWNER/MD
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Name | SARA KAKISH
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Credential | MD
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Telephone | 314-471-9119
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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 |
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License Number State |
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