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Organization
BALLWIN FAMILY MEDICINE LLC
Active
Organization
BALLWIN FAMILY MEDICINE LLC
Active
Parent organization
ST. LUKES MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. LUKES MEDICAL GROUP
Authorized official
JAMES SNIDER (DIRECTOR)
(636) 685-7804
Entity
Organization
Contact information
Practice address
653 BIG BEND RD, MANCHESTER, MO 63021-7723
(314) 434-1500
Mailing address
653 BIG BEND RD, MANCHESTER, MO 63021-7723
(314) 434-1500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/14/2017
Last updated
01/27/2022
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