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Organization

MSA ALLIANCE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES B. DAVIS (EXECUTIVE DIRECTOR)
(618) 257-4644
Entity
Organization

Contact information

Practice address
4550 MEMORIAL DR STE 340, SUITE 340, BELLEVILLE, IL 62226-5372
(618) 257-6302
(618) 257-4838
Mailing address
4500 MEMORIAL DRIVE, MEMORIAL HOSPITAL MEDICAL AFFAIRS, BELLEVILLE, IL 62226
(618) 257-4644

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary

Other

Enumeration date
09/23/2014
Last updated
09/23/2014
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