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General NPI Number Information
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NPI Number | 1710287099
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Entity Type | Organization
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Legal Business Name | UROLOGY TODAY, LLC
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Dates
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Enumeration Date | 11/02/2010
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 1479 HWY 61 SUITE B
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City | CRYSTAL CITY
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State | MO
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Zip | 63019-0604
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Country | US
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Telephone | 636-937-8883
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Fax |
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Provider Business Mailing Address
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Address Line | 1479 HWY 61 SUITE B
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City | CRYSTAL CITY
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State | MO
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Zip | 63019-0604
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Country | US
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Telephone | 636-937-8883
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Fax |
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Authorized Official
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Title or Position | MEMBER/DIRECTOR
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Name | MR. GREGORY ALLEN BRUMMETT
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Credential | MBA
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Telephone | 636-937-8883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State | MO
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