Organization
BALLWIN ORTHOPEDIC GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALYSSA VISCONTI (PRACTICE MANAGER)
(314) 322-9254
Entity
Organization
Contact information
Practice address
884 WOODS MILL RD, STE 202, BALLWIN, MO 63011-3657
(314) 322-9254
Mailing address
884 WOODS MILL RD, STE 202, BALLWIN, MO 63011-3657
(314) 322-9254
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
05/19/2014
Last updated
05/19/2014
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