New Balance Lake St. Louis
NPI #1114165263 in Lake St Louis, Missouri
Provider Information
- NPI Number
- 1114165263
- Entity Type
- Organization
- Organization Name
- New Balance Lake St. Louis
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- BROWN'S ENTERPRISES
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Jan 28, 2009
- Last Updated
- Jan 28, 2009
Practice Location
- Address
- 21 MEADOWS CIRCLE DR
- Address 2
- SUITE 314
- City
- Lake St Louis
- State
- Missouri
- ZIP Code
- 63367-4109
- Phone
- (636) 561-2204
Authorized Official
- Name
- MR. CHAD LOUIS BROWN, C.PED
- Title
- CERTIFIED PEDORTHIST
- Phone
- (636) 561-2204
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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