Organization
HEALTHMARK BALLAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY SUE EKSTROM (OFFICE MANAGER)
(314) 446-0050
Entity
Organization
Contact information
Practice address
456 N NEW BALLAS RD STE 266, SAINT LOUIS, MO 63141-6842
(314) 373-7000
(314) 373-7003
Mailing address
11600 MANCHESTER RD STE 101, SAINT LOUIS, MO 63131-4691
(314) 446-0050
(314) 822-8476
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/09/2007
Last updated
08/22/2020
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