Organization
MISSOURI IMAGING AFFILIATES LLC
Active
Other names
Clinical PET of West County
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN MICHAEL MCRAE (MANAGING MEMBER)
(618) 659-1167
Entity
Organization
Contact information
Practice address
450 N NEW BALLAS RD, CREVE COEUR, MO 63141-6835
(314) 567-4343
(314) 567-4346
Mailing address
PO BOX 868, EDWARDSVILLE, IL 62025-0868
(618) 659-1167
(618) 659-1197
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/19/2005
Last updated
08/22/2020
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