Organization
LIFEWAVE TECHNOLOGY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALYSEN BAER (MANAGER)
(314) 880-0717
Entity
Organization
Contact information
Practice address
8637 DELMAR BLVD, SAINT LOUIS, MO 63124-1906
(314) 880-0717
Mailing address
8637 DELMAR BLVD, SAINT LOUIS, MO 63124-1906
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
05/30/2012
Last updated
09/12/2018
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