Organization
PATRICIA REALTY
Active
Parent organization
LAURIES SHOES
Other names
LAURIES SHOES
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAURIES SHOES
Authorized official
TEENA MCADAMS (ACCOUNTING)
(314) 604-2154
Entity
Organization
Contact information
Practice address
9916 MANCHESTER RD, SAINT LOUIS, MO 63122-1989
(314) 961-1642
Mailing address
9916 MANCHESTER RD, SAINT LOUIS, MO 63122-1989
(314) 961-1642
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
04/26/2023
Last updated
04/26/2023
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