Individual
TORNIKE MAMULADZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
660 S EUCLID AVE, SAINT LOUIS, MO 63110-1010
(434) 227-2428
Mailing address
660 S EUCLID AVE, SAINT LOUIS, MO 63110-1010
(434) 227-2428
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MO
Other
Enumeration date
04/30/2026
Last updated
04/30/2026
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