Organization
IDIM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDRE LACASSE M.D. (PRESIDENT)
(636) 273-5311
Entity
Organization
Contact information
Practice address
1909 LARIMER TRL, WILDWOOD, MO 63011-4801
(636) 273-5311
Mailing address
1909 LARIMER TRL, WILDWOOD, MO 63011-4801
(636) 273-5311
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
2006028227
MO
Other
Enumeration date
08/27/2012
Last updated
11/16/2012
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