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1255332904
CHARLES DAVID ETTELSON
SAINT LOUIS, MO
NPI
1255332904
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2086S0122X Surgery Plastic and Reconstructive Surgery
(Licence: MO R9446)
Enumeration Date
2005-08-03
Last Update Date
2013-07-02
Business Address
DR. CHARLES DAVID ETTELSON M.D.
730 AUDUBON DR
SAINT LOUIS, MO 63105-2906
Phone number: 314-324-7605
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Mailing Address
DR. CHARLES DAVID ETTELSON M.D.
730 AUDUBON DR
SAINT LOUIS, MO 63105-2906
Phone number: 314-324-7605
Copy
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