Organization
LICE BUSTERS ST. LOUIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH LUTZ (OWNER)
(314) 973-9837
Entity
Organization
Contact information
Practice address
7923 BIG BEND BLVD, SAINT LOUIS, MO 63119-2703
(314) 329-5423
Mailing address
7923 BIG BEND BLVD, SAINT LOUIS, MO 63119-2703
(314) 329-5423
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/15/2017
Last updated
07/21/2022
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