Organization
ST LOUIS PAIN MANAGEMENT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM DEBOLD (ACCT MANAGER)
(314) 432-2580
Entity
Organization
Contact information
Practice address
11605 STUDT AVE, SUITE 120, SAINT LOUIS, MO 63141-7052
(314) 432-2580
(314) 569-3162
Mailing address
PO BOX 1209, MARYLAND HEIGHTS, MO 63043-0209
(314) 432-2580
(314) 432-0223
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
10/05/2006
Last updated
11/18/2013
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