# ST LOUIS PAIN MANAGEMENT CENTER

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

## Provider details

- **NPI number:** 1811072143
- **Authorized official:** LYNN HENDERSON (ACCT MANAGER)
- **Authorized official phone:** (314) 432-2580

## Contact information

- **Practice address:** 777 N NEW BALLAS RD, ST LOUIS, MO 63141
- **Practice address phone:** (314) 432-2580
- **Practice address fax:** (314) 432-0223
- **Mailing address:** PO BOX 1209, MARYLAND HEIGHTS, MO 63043-0209
- **Mailing address phone:** (314) 432-2580
- **Mailing address fax:** (314) 432-0223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 08/22/2020