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Organization
STL SURGICAL LLC
Active
Organization
STL SURGICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN BRANNON ADMINISTRATOR (ADMINISTRATOR)
(502) 303-0919
Entity
Organization
Contact information
Practice address
12184 NATURAL BRIDGE RD, BRIDGETON, MO 63044-2017
(314) 481-3037
Mailing address
5203 CHIPPEWA ST STE 301, SAINT LOUIS, MO 63109-2356
(314) 481-5000
(314) 481-3037
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2017
Last updated
02/13/2019
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