Organization Name: | ST LOUIS UNIVERSITY |
NPI Number: | 1104899459 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALYCE LANXON (DIRECTOR) |
Mailing Address: | 3635 Vista Ave Saint Louis |
State: | MO US |
Postal Code: | 631102539 |
Phone Number: | 3149776828 |
Fax Number: | 3142685116 |
NPI Enumeration Date: | 02/08/2006 |
NPI Last Update Date: | 07/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |