Organization
MASON RIDGE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER ROTHROCK MD (PRESIDENT)
(314) 878-7150
Entity
Organization
Contact information
Practice address
12855 N OUTER 40, SUITE 100, SAINT LOUIS, MO 63141-8635
(314) 878-7150
(314) 878-3051
Mailing address
12855 N OUTER 40, SUITE 100, SAINT LOUIS, MO 63141-8635
(314) 878-7150
(314) 878-3051
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
180-0
MO
Other
Enumeration date
05/12/2006
Last updated
03/17/2008
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