Modern Vascular of St Louis LLC
NPI #1972106391 in Creve Coeur, Missouri
Provider Information
- NPI Number
- 1972106391
- Entity Type
- Organization
- Organization Name
- Modern Vascular of St Louis LLC
- Primary Specialty
- Radiology - Vascular & Interventional Radiology
- Enumeration Date
- Nov 18, 2020
- Last Updated
- Nov 18, 2020
Practice Location
- Address
- 641 N NEW BALLAS RD
- City
- Creve Coeur
- State
- Missouri
- ZIP Code
- 63141-6713
- Phone
- (314) 648-0101
Authorized Official
- Name
- YURY GAMPEL
- Title
- CEO
- Phone
- (818) 880-8605
Specialties & Taxonomy Codes
| Specialty |
|---|
| Radiologic Technologist - Vascular-Interventional Technology — Vascular-Interventional Technology |
| Radiology - Vascular & Interventional Radiology — Vascular & Interventional Radiology |
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