Organization
HEALTHMARK GRAVOIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY SUE EKSTROM (OFFICE MANAGER)
(314) 446-0050
Entity
Organization
Contact information
Practice address
9701 LANDMARK PARKWAY DR STE 102, SAINT LOUIS, MO 63127-1665
(314) 446-0050
(314) 822-8476
Mailing address
11600 MANCHESTER RD STE 1O1, SAINT LOUIS, MO 63131-4691
(314) 446-0050
(314) 822-8476
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/09/2007
Last updated
08/22/2020
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