Organization
MSA ALLIANCE, LLC
Active
Parent organization
MSA ALLIANCE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MSA ALLIANCE, LLC
Authorized official
JAMES B. DAVIS (EXECUTIVE DIRECTOR)
(618) 257-4644
Entity
Organization
Contact information
Practice address
1 BROADWAY PLZ, SPARTA, IL 62286-1800
(618) 257-2100
Mailing address
4500 MEMORIAL DR, MEDICAL AFFAIRS CREDENTIALING DEPT, BELLEVILLE, IL 62226-5360
(618) 257-4644
(618) 257-6946
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
02/14/2013
Last updated
02/25/2013
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