Organization
BLUETAIL BIOLOGICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE ONEIL (PRACTICE ADMINISTRATOR)
(636) 778-2826
Entity
Organization
Contact information
Practice address
17300 N OUTER 40 RD STE 201, CHESTERFIELD, MO 63005-1364
(636) 778-2900
(636) 778-2828
Mailing address
17300 N OUTER 40 RD STE 201, CHESTERFIELD, MO 63005-1364
(636) 778-2900
(636) 778-2828
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
10/23/2018
Last updated
10/23/2018
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