Organization
LEGACY MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG KISER (OWNER)
(314) 703-5618
Entity
Organization
Contact information
Practice address
757 RUDDER RD, FENTON, MO 63026-2014
(314) 703-5618
Mailing address
757 RUDDER RD, FENTON, MO 63026-2014
(314) 703-5618
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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