Organization
IDEAL PEDIATRIC WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSPEH CANGAS MD (MEMBER)
(314) 270-9355
Entity
Organization
Contact information
Practice address
10007 KENNERLY RD STE C, SAINT LOUIS, MO 63128-2179
(314) 270-9355
Mailing address
9788 GERALD DR, SAINT LOUIS, MO 63128-1708
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
12/06/2017
Last updated
12/06/2017
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