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Organization
MISSOURI PODIATRIC SURGICARE LLC
Active
Organization
MISSOURI PODIATRIC SURGICARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN M DAILEY DPM, MBA, FACFAOM (PRESIDENT)
(636) 239-0018
Entity
Organization
Contact information
Practice address
851 E 5TH ST, SUITE 228, WASHINGTON, MO 63090-3135
(636) 239-0018
Mailing address
851 E 5TH ST, SUITE 228, WASHINGTON, MO 63090-3135
(636) 239-0018
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
000689
MO
261QP1100X
Podiatric Clinic/Center
000689
MO
Other
Enumeration date
04/25/2008
Last updated
04/25/2008
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