Organization
ST. LOUIS SPINE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN WILSON (CHIEF FINANCIAL OFFICER)
(615) 301-8144
Entity
Organization
Contact information
Practice address
633 EMERSON RD, SUITE 160, CREVE COEUR, MO 63141-6739
(314) 569-2007
Mailing address
633 EMERSON RD, SUITE 160, CREVE COEUR, MO 63141-6739
(314) 569-2007
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/08/2012
Last updated
11/26/2012
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