Individual
MARTINA KUKOLJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12647 OLIVE BLVD STE 600, SAINT LOUIS, MO 63141-6346
(314) 744-4205
Mailing address
12647 OLIVE BLVD STE 600, SAINT LOUIS, MO 63141-6346
(314) 744-4205
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101050160
VA
Other
Enumeration date
12/18/2012
Last updated
12/18/2012
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