Organization
OLIVE SURGICAL GROUP, LTD.
Active
Organization
OLIVE SURGICAL GROUP, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN JANE HUMPHRIES (OFFICE MANAGER)
(314) 699-9818
Entity
Organization
Contact information
Practice address
11605 STUDT AVE, SUITE ONE, SAINT LOUIS, MO 63141-7052
(314) 699-9818
(314) 699-9868
Mailing address
11605 STUDT AVE, SUITE ONE, SAINT LOUIS, MO 63141-7052
(314) 699-9818
(314) 699-9868
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/20/2006
Last updated
12/18/2008
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