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General NPI Number Information
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NPI Number | 1811319320
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Entity Type | Organization
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Legal Business Name | ST. ANTHONY'S PHYSICIAN ORGANIZATION
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Dates
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Enumeration Date | 01/17/2014
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Last Update Date | 01/04/2019
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Provider Practice Location Address
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Address Line | 10004 KENNERLY RD SUITE 205A
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2141
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Country | US
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Telephone | 314-525-4327
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Fax | 314-525-4368
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Provider Business Mailing Address
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Address Line | 10004 KENNERLY RD SUITE 205A
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2141
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Country | US
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Telephone | 314-525-4327
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Fax | 314-525-4368
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Authorized Official
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Title or Position | CFO EAST COMMUNITIES & SFO
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Name | MS. CHERYL MATEJKA
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Credential |
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Telephone | 314-251-1958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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