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Organization

ST. LOUIS CENTER OF PREVENTITIVE & LONGEVITY MEDICINE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD A. BLIGH MD (PHYSICIAN)
(314) 721-0666
Entity
Organization

Contact information

Practice address
1034 S BRENTWOOD BLVD, SUITE 1060, SAINT LOUIS, MO 63117-1223
(314) 721-0666
(314) 727-9612
Mailing address
1836 LACKLAND HILL PKWY, ATTN CREDENTIALING DEPAT, SAINT LOUIS, MO 63146-3572
(314) 989-0300

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD102881
MO

Other

Enumeration date
03/19/2007
Last updated
08/22/2020
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