Pediatric Neurodevelopmental Center LLC

NPI #1639500192 in Chesterfield, Missouri

Provider Information

NPI Number
1639500192
Entity Type
Organization
Organization Name
Pediatric Neurodevelopmental Center LLC
Primary Specialty
Pediatrics
Enumeration Date
Dec 10, 2013
Last Updated
Dec 10, 2013

Practice Location

Address
17300 N OUTER 40 RD
Address 2
SUITE 205
ZIP Code
63005-1364
Phone
(636) 778-9212

Authorized Official

Name
DR. AVI E. DOMNITZ-GEBET, D.O.
Title
AUTHORIZED REP/ OWNER/ MD
Phone
(636) 778-9212

Specialties & Taxonomy Codes

Specialty
Pediatrics

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