Organization
PRO PAIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BOEDEFELD MD (OWNER)
(636) 442-5035
Entity
Organization
Contact information
Practice address
1055 BOWLES AVE STE 202, FENTON, MO 63026-2308
(636) 326-7821
Mailing address
4800 MEXICO RD STE 101, SAINT PETERS, MO 63376-1666
(636) 442-5035
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
03/17/2018
Last updated
12/06/2018
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