STATE OF MISSOURI is a general practice in Saint Charles, MO. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Source: National Uniform Claim Committee STATE OF MISSOURI NPI is 1316991896. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As St. Louis Developmental Disabilities Treatment Center.
The provider's business location address is:
22 MARR LN
SAINT CHARLES, MO
ZIP 63303-000
Phone: (314) 340-6702
Fax: (314) 340-6724
The provider's authorized official is Molly Jane Boeckmann .
The authorized official title is Director Of Administrative Services and has the following contact phone number (573) 751-4055.
The enumeration date for this NPI number is 5/20/2006 and was last updated on 10/20/2020.