SSM ST CHARLES CLINIC MEDICAL GROUP

LAKE ST LOUIS, MO
NPI1518396670
Entity TypeOrganization
Authorized ContactLAURA PULLUM
Director
636-669-2434
Organization Subpart ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MO  2013015582)
Enumeration Date2013-11-08
Last Update Date2013-11-08
Business Address
SSM ST CHARLES CLINIC MEDICAL GROUP
400 MEDICAL PLZ SUITE 200
LAKE ST LOUIS, MO 63367-1490
Phone number: 636-625-2662
Mailing Address
SSM ST CHARLES CLINIC MEDICAL GROUP
1551 WALL ST SUITE 310
SAINT CHARLES, MO 63303-3539
Phone number: 636-669-2268