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General NPI Number Information
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NPI Number | 1578733374
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Entity Type | Organization
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Legal Business Name | HEALING CENTER OF ST LOUIS, LLC
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Dates
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Enumeration Date | 03/07/2008
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 1001 S KIRKWOOD RD SUITE 160
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City | KIRKWOOD
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State | MO
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Zip | 63122-7254
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Country | US
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Telephone | 314-984-0461
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Fax | 314-909-8981
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Provider Business Mailing Address
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Address Line | 1001 S KIRKWOOD RD SUITE 160
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City | KIRKWOOD
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State | MO
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Zip | 63122-7254
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Country | US
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Telephone | 314-984-0461
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Fax | 314-909-8981
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGORY C RINEHART
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Credential | M.D.
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Telephone | 314-984-0461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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