Organization
STL GATEWAY HEALTH CARE LLC
Active
Other names
STL Gateway Health Care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM CLENDENIN MD (PRESIDENT)
(314) 799-2750
Entity
Organization
Contact information
Practice address
7428 ETHEL AVE, SAINT LOUIS, MO 63117-1608
(314) 799-2750
Mailing address
7428 ETHEL AVE, SAINT LOUIS, MO 63117-1608
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
09/01/2022
Last updated
09/01/2022
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