Organization
MEN'S MEDICAL INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL MIMLITZ M.D. (MANAGER)
(314) 394-1660
Entity
Organization
Contact information
Practice address
1062 OLD DES PERES RD, SAINT LOUIS, MO 63131-1865
(314) 394-1660
(314) 394-1663
Mailing address
1062 OLD DES PERES RD, SAINT LOUIS, MO 63131-1865
(314) 394-1660
(314) 394-1663
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
2017006602
MO
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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