St Louis University
NPI #1336368034 in Saint Louis, Missouri
Provider Information
- NPI Number
- 1336368034
- Entity Type
- Organization
- Organization Name
- St Louis University
- Primary Specialty
- Pediatrics - Sports Medicine
- Enumeration Date
- Apr 24, 2007
- Last Updated
- Sep 21, 2021
Practice Location
- Address
- 1465 S GRAND BLVD
- City
- Saint Louis
- State
- Missouri
- ZIP Code
- 63104-1003
- Phone
- (314) 577-5643
Authorized Official
- Name
- ALYCE LANXON
- Title
- EXECUTIVE DIRECTOR
- Phone
- (314) 977-6828
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics - Sports Medicine — Sports Medicine |
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