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Organization
ST. LOUIS DEPARTMENT OF VETERANS AFFAIRS
Active
Organization
ST. LOUIS DEPARTMENT OF VETERANS AFFAIRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BROOKE MARIE THEODORAKOS M.S., R.D., L.D. (REGISTERED DIETITIAN)
(314) 652-4100
Entity
Organization
Contact information
Practice address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 652-4100
Mailing address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 652-4100
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2009000717
MO
Other
Enumeration date
02/07/2011
Last updated
02/07/2011
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