Organization
ST. LOUIS CENTERS FOR PAIN MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL LIBERMAN DC (OWNER)
(314) 858-1858
Entity
Organization
Contact information
Practice address
3555 SUNSET OFFICE DR STE C102, SAINT LOUIS, MO 63127-1014
(314) 858-1858
(314) 261-5043
Mailing address
3555 SUNSET OFFICE DR STE C102, SAINT LOUIS, MO 63127-1014
(314) 858-1858
(314) 261-5043
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
112767
MO
208D00000X
General Practice Physician
112767
MO
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26D2077922
CLIA
MO
Enumeration date
11/09/2011
Last updated
02/11/2019
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