# STL INJURY AND SPINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134744725
- **Authorized official:** DR. JERRY LEECH DC (CEO)
- **Authorized official phone:** (314) 972-3107

## Contact information

- **Practice address:** 7721 CLAYTON RD, CLAYTON, MO 63117-1301
- **Practice address phone:** (314) 546-6072
- **Practice address fax:** (888) 569-4961
- **Mailing address:** 7721 CLAYTON RD, CLAYTON, MO 63117-1301
- **Mailing address phone:** (314) 546-6072
- **Mailing address fax:** (888) 569-4961

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2081N0008X | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 06/10/2020
- **Last updated:** 06/10/2020