Individual
MR. KEVIN L QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.A.
Contact information
Practice address
615 S NEW BALLAS RD, DEPT. OF ANESTHESIA, SAINT LOUIS, MO 63141-8221
(314) 251-6000
Mailing address
339 CONSORT DR, BALLWIN, MO 63011-4439
(636) 386-9224
(636) 200-4243
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
2009029105
MO
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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