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Organization

ORTHOPEDIC CENTER OF ST LOUIS IMG LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEN KILEN (ADMINISTRATOR)
(314) 336-2555
Entity
Organization

Contact information

Practice address
14825 N OUTER 40 RD STE 200, CHESTERFIELD, MO 63017-2152
(314) 336-2555
(314) 336-2557
Mailing address
14825 N OUTER 40 RD STE 200, CHESTERFIELD, MO 63017-2152
(314) 336-2555
(314) 336-2557

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Enumeration date
01/09/2024
Last updated
01/09/2024
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