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1184281909
JORDAN TRACE PERKINS
SAINT LOUIS, MO
NPI
1184281909
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208600000X Surgery
(Licence: MO 2021021646)
Enumeration Date
2019-05-28
Last Update Date
2021-06-14
Business Address
JORDAN TRACE PERKINS MD
1008 S SPRING AVE
SAINT LOUIS, MO 63110-2520
Phone number: 314-977-1642
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Mailing Address
JORDAN TRACE PERKINS MD
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104-1004
Phone number: 314-977-1642
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