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Organization
DES PERES SQUARE IMAGING CENTER LLC
Active
Organization
DES PERES SQUARE IMAGING CENTER LLC
Active
Parent organization
ORTHOPEDIC ASSOCIATES LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORTHOPEDIC ASSOCIATES LLC
Authorized official
MR. LARRY W POLLEY (EXECUTIVE DIRECTOR)
(314) 569-0612
Entity
Organization
Contact information
Practice address
1050 OLD DES PERES RD, SUITE 75, SAINT LOUIS, MO 63131-1873
(314) 569-2412
(314) 569-1655
Mailing address
1050 OLD DES PERES RD, SUITE 100, SAINT LOUIS, MO 63131-1873
(314) 569-2412
(314) 569-1655
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/09/2005
Last updated
03/09/2011
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