Organization
MSA ALLIANCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES B. DAVIS (EXECUTIVE DIRECTOR)
(618) 257-4644
Entity
Organization
Contact information
Practice address
2133 VADALABENE DR, SUITE 2, MARYVILLE, IL 62062-5839
(618) 222-1020
(618) 222-1039
Mailing address
4500 MEMORIAL DRIVE, MEMORIAL HOSPITAL MEDICAL AFFAIRS, BELLEVILLE, IL 62226
(618) 257-4644
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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