Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Jul 10, 2017
License(s)
2022004026 (MO), 2022004026 (MO)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 510 S KINGSHIGHWAY BLVD DEPT RADIOLOGY | Saint Louis, MO 63110-1016 | 314-362-7200 |
| MAILING | PO BOX 7412011 | Chicago, IL 60674-2011 | 314-362-7200 |
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