Organization
SSM DEPAUL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY MOORE MD (VICE PRESIDENT OF ACADEMIC AFFAIRS)
(314) 334-6971
Entity
Organization
Contact information
Practice address
12303 DE PAUL DR, BRIDGETON, MO 63044-2512
(314) 334-6971
Mailing address
12303 DEPAUL DRIVE, BRIDGETON, MO 63044
Taxonomy
Speciality
Code
Description
License number
State
211D00000X
Podiatric Assistant
Primary
—
—
Other
Enumeration date
06/25/2013
Last updated
06/25/2013
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