Mia of St Charles County LLC
NPI #1922093632 in Saint Charles, Missouri
Provider Information
- NPI Number
- 1922093632
- Entity Type
- Organization
- Organization Name
- Mia of St Charles County LLC
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Sep 19, 2005
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1475 KISKER RD
- Address 2
- STE 145
- City
- Saint Charles
- State
- Missouri
- ZIP Code
- 63304-8781
- Phone
- (636) 922-5151
Authorized Official
- Name
- MR. STEVEN MICHAEL MCRAE
- Title
- MANAGING MEMBER
- Phone
- (618) 659-1167
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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