Organization
PRO PHYSICIANS CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON TRYGGESTAD (CEO)
(972) 573-4611
Entity
Organization
Contact information
Practice address
450 N NEW BALLAS RD STE 70W, SAINT LOUIS, MO 63141-6833
(314) 665-3096
Mailing address
PO BOX 678234, DALLAS, TX 75267-8234
(512) 583-0205
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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