Individual
MR. BLAIR ANTHONY MALENCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
(314) 996-5225
(314) 991-0943
Mailing address
660 S EUCLID AVE, CB 8072, SAINT LOUIS, MO 63110-1010
(314) 996-5225
(314) 991-0943
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.004418
IL
363A00000X
Physician Assistant
2012032511
MO
Other
Enumeration date
06/26/2012
Last updated
05/09/2024
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