Organization
THE ORTHOPEDIC CENTER OF ST. LOUIS
Active
Other names
MFG Spine
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY MATTINGLY (FINANCIALS)
(314) 336-2620
Entity
Organization
Contact information
Practice address
14825 N OUTER 40, SUITE 200, CHESTERFIELD, MO 63017-2152
(314) 336-2555
(314) 336-2557
Mailing address
14825 N OUTER 40, SUITE 200, CHESTERFIELD, MO 63017-2152
(314) 336-2555
(314) 336-2557
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36909
MO
Other
Enumeration date
10/17/2006
Last updated
08/22/2020
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