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Organization
ST LOUIS PAIN MANAGEMENT CENTER INC
Active
Organization
ST LOUIS PAIN MANAGEMENT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM DEBOLD (ACCT MANAGER)
(314) 432-2580
Entity
Organization
Contact information
Practice address
11605 STUDT AVE, SUITE 120, SAINT LOUIS, MO 63141-7052
(314) 432-2580
(314) 569-3162
Mailing address
PO BOX 1209, MARYLAND HEIGHTS, MO 63043-0209
(314) 432-2580
(314) 432-0223
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
10/05/2006
Last updated
11/18/2013
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