Organization
ST. LOUIS DEPARTMENT OF VETERANS AFFAIRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BROOKE MARIE THEODORAKOS M.S., R.D., L.D. (REGISTERED DIETITIAN)
(314) 652-4100
Entity
Organization
Contact information
Practice address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 652-4100
Mailing address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 652-4100
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2009000717
MO
Other
Enumeration date
02/07/2011
Last updated
02/07/2011
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