Organization
SSM REGIONAL HEALTH SERVICES
Active
Parent organization
SSM REGIONAL HEALTH SERVICES
Other names
Center for Plastics & Restorative Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM REGIONAL HEALTH SERVICES
Authorized official
BRENT VAN CONIA (PRESIDENT)
(573) 761-7000
Entity
Organization
Contact information
Practice address
200 SAINT MARYS PLZ, SUITE 201, JEFFERSON CITY, MO 65101-1604
(573) 632-4325
(573) 659-2503
Mailing address
PO BOX 1027, JEFFERSON CITY, MO 65102-1027
(573) 632-4325
(573) 761-2006
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/31/2006
Last updated
12/13/2007
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