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Organization

WINGHAVEN PEDIATRICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HOLLY LOEFFLER (OFFICE MANAGER)
(636) 561-5561
Entity
Organization

Contact information

Practice address
5551 WINGHAVEN BLVD, O FALLON, MO 63368-3617
(636) 561-5561
(636) 561-5557
Mailing address
5551 WINGHAVEN BLVD, SUITE 240, O'FALLON, MO 63368
(636) 561-5561
(636) 561-5557

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
03/15/2007
Last updated
04/22/2009
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