Organization
ST LOUIS UNIVERSITY
Active
Other names
SLUCARE DEPT OF PEDIATRIC SPORT MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
ALYCE LANXON (EXECUTIVE DIRECTOR)
(314) 977-6828
Entity
Organization
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5643
Mailing address
3545 LINDELL BLVD FL 3, SAINT LOUIS, MO 63103-1020
(314) 977-6828
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
Primary
—
—
Other
Enumeration date
04/24/2007
Last updated
09/21/2021
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