Dermatology At Winghaven, Llc Valid NPI

Organization · Specialist · O Fallon, MO

NPI

1982777413

Type

Organization (Type 2)

Primary specialty

Specialist

Specialty group

Other Service Providers

Taxonomy code

174400000X

License number

2004011011 (MO)

Enumerated

2006-11-15

Last updated

2020-08-22