KEVIN JAMES LICKENBROCK

SAINT LOUIS, MO
NPI1174643845
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: MO  100453)
Enumeration Date2007-03-29
Last Update Date2007-07-08
Business Address
-- KEVIN JAMES LICKENBROCK M.D.
2900 LEMAY FERRY RD SUITE 100
SAINT LOUIS, MO 63125-3900
Phone number: 314-543-5294
Mailing Address
-- KEVIN JAMES LICKENBROCK M.D.
1159 ALBANY CT
SAINT LOUIS, MO 63119-4733
Phone number: 314-961-4098
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