Organization
PACE MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL CANTRELL MD (SOLE MEMBER)
(314) 451-2225
Entity
Organization
Contact information
Practice address
343 S KIRKWOOD RD STE 205, KIRKWOOD, MO 63122-6195
(314) 451-2225
Mailing address
343 S KIRKWOOD RD STE 205, KIRKWOOD, MO 63122-6195
(314) 451-2225
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
10/05/2021
Last updated
10/12/2021
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