Organization
AESTHETIC AND HAND SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELE D. KOO M.D. (OWNER)
(314) 984-8331
Entity
Organization
Contact information
Practice address
333 S. KIRKWOOD RD., SUITE 203, ST. LOUIS, MO 63122
(314) 984-8331
(314) 821-8377
Mailing address
333 S KIRKWOOD RD, SUITE 203, SAINT LOUIS, MO 63122-6161
(314) 984-8331
(314) 821-8377
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2002007887
MO
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
Primary
102697
MO
Other
Enumeration date
10/04/2006
Last updated
10/15/2008
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