Organization
MIDWEST DERMAL SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMMIE MARIE AUER REGISTERED NURSE (OWNER)
(314) 954-5568
Entity
Organization
Contact information
Practice address
1423 VILLAS ESTATES DR, FENTON, MO 63026-3284
(314) 954-5568
(636) 825-9568
Mailing address
1423 VILLAS ESTATES DR, FENTON, MO 63026-3284
(314) 954-5568
(636) 825-9568
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
132832
MO
Other
Enumeration date
04/10/2009
Last updated
04/10/2009
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