# KIRKWOOD DIAGNOSTIC & ORTHOPEDIC ASSOCIATES, LLC.

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

## Provider details

- **NPI number:** 1295839702
- **Authorized official:** DAVE HORACE (BUSINESS MANAGER)
- **Authorized official phone:** (314) 909-1666

## Contact information

- **Practice address:** 333 S KIRKWOOD RD, SUITE 203, SAINT LOUIS, MO 63122-6161
- **Practice address phone:** (314) 909-1666
- **Practice address fax:** (314) 909-7406
- **Mailing address:** 333 S KIRKWOOD RD, SUITE 203, SAINT LOUIS, MO 63122-6161
- **Mailing address phone:** (314) 909-1666
- **Mailing address fax:** (314) 909-7406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | 109216 | MO | Yes |

## Other

- **Enumeration date:** 09/13/2006
- **Last updated:** 08/22/2020