Organization
FRG RLT HOLDINGS, INC.
Active
Other names
St Joseph Obstetrics and Gynecology
Organization subpart
No
Provider details
NPI number
Authorized official
AMY L ELLIOTT (ACCOUNT MANAGER)
(314) 593-2694
Entity
Organization
Contact information
Practice address
1747 SMIZER STATION RD STE 1, FENTON, MO 63026-2784
(636) 861-2125
(636) 861-1691
Mailing address
PO BOX 790379, SAINT LOUIS, MO 63179-0379
(314) 628-1405
(314) 878-4562
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H08266
UPIN
—
Enumeration date
11/13/2018
Last updated
07/03/2024
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