Individual
MR. BARON K SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
729 W US HIGHWAY 50, STE F, O FALLON, IL 62269-1972
(618) 447-3392
Mailing address
729 W US HIGHWAY 50, STE F, O FALLON, IL 62269-1972
(618) 447-3392
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
3949-4810
IL
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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