Organization
SUNFLOWER PODIATRY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNESSA RENEE BLACKMUN DPM (ADMINISTRATOR)
(502) 418-4809
Entity
Organization
Contact information
Practice address
1316 HEBERT STREET, SAINT LOUIS, MO 63107
(314) 884-8549
Mailing address
1316 HEBERT ST, SAINT LOUIS, MO 63107-3915
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2010035799
MO
Other
Enumeration date
09/18/2017
Last updated
09/18/2017
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