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1700872611
JERRY M LIDDELL
SAINT LOUIS, MO
NPI
1700872611
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
213ES0103X Podiatrist, Foot & Ankle Surgery
(Licence: MO 2005018735)
Enumeration Date
2005-09-26
Last Update Date
2024-04-25
Business Address
Mr. JERRY M LIDDELL DPM
4901 FOREST PARK AVE DIV SURG ACCS PODIATRY, STE 420
SAINT LOUIS, MO 63108-1495
Phone number: 314-747-4769
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Mailing Address
Mr. JERRY M LIDDELL DPM
PO BOX 60352
SAINT LOUIS, MO 63160-0352
Phone number: 314-747-4769
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