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General NPI Number Information
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NPI Number | 1730950155
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC SPINE CENTER LLC
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 10296 BIG BEND RD STE 205
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City | SAINT LOUIS
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State | MO
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Zip | 63122-6582
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Country | US
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Telephone | 314-788-9907
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Fax | 833-418-1951
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Provider Business Mailing Address
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Address Line | 10296 BIG BEND RD STE 205
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City | SAINT LOUIS
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State | MO
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Zip | 63122-6582
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Country | US
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Telephone | 314-788-9907
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Fax | 833-418-1951
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | CATHERINE LANHAM
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Credential |
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Telephone | 314-788-9907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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