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Organization

LA CLINICA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID C CAMPBELL M.D. M.ED. (EXECUTIVE DIRECTOR)
(314) 664-5565
Entity
Organization

Contact information

Practice address
3646 FAIRVIEW AVE, SAINT LOUIS, MO 63116-4747
(314) 664-5564
(314) 773-0709
Mailing address
3646 FAIRVIEW AVE, SAINT LOUIS, MO 63116-4747
(314) 664-5564
(314) 773-0709

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
07/02/2007
Last updated
08/22/2020
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