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General NPI Number Information
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NPI Number | 1659354645
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Entity Type | Organization
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Legal Business Name | STROMSDORFER-TOLOD MEDICAL LAB LTD.
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | 1 SAINT ANTHONYS WAY
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City | ALTON
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State | IL
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Zip | 62002-4568
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Country | US
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Telephone | 618-465-4511
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Fax | 618-474-6018
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Provider Business Mailing Address
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Address Line | PO BOX 1063
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City | ALTON
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State | IL
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Zip | 62002-1063
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Country | US
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Telephone | 314-821-8055
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Fax | 314-821-1833
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Authorized Official
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Title or Position | M.D.
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Name | PAUL G STROMSDORFER
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Credential |
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Telephone | 618-465-4511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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