Organization
ST. LOUIS CENTER FOR PREVENTATIVE AND LONGEVITY MEDICINE
Active
Parent organization
ST. LOUIS CENTER FOR PREVENTATIVE AND LONGEVITY MEDICINE
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. LOUIS CENTER FOR PREVENTATIVE AND LONGEVITY MEDICINE
Authorized official
DR. RICHARD BLIGH M.D. (MEDICAL DIRECTOR)
(413) 994-1536
Entity
Organization
Contact information
Practice address
777 S NEW BALLAS RD, SUITE 200E, SAINT LOUIS, MO 63141-8705
(413) 994-1536
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
12/08/2011
Last updated
12/08/2011
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