Organization
BRIDGETON PAIN GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITCHELL LIBERMAN (PRESIDENT)
(314) 526-6093
Entity
Organization
Contact information
Practice address
11520 SAINT CHARLES ROCK RD STE 201, BRIDGETON, MO 63044
(314) 526-6093
Mailing address
11520 SAINT CHARLES ROCK RD STE 201, BRIDGETON, MO 63044-2732
(314) 526-6093
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/27/2023
Last updated
10/30/2023
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