Organization
JHP SPINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY GARDNER (CREDENTIALING SPECIALIST)
(636) 778-3634
Entity
Organization
Contact information
Practice address
14825 N OUTER 40 RD STE 310, CHESTERFIELD, MO 63017-2152
(636) 778-3634
Mailing address
14825 N OUTER 40 RD STE 310, CHESTERFIELD, MO 63017-2152
(636) 778-3634
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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