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Dr. Louis P Stickley
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NPI Number Detailed Information
Provider Information:
| Name: | Dr. Louis P Stickley |
| Gender: | M |
| Provider License Number If Given: | 30591 |
NPI Information:
| NPI: | 1295738201 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 5/23/2005 |
| Last Update Date: | 4/29/2014 |
Provider Business Mailing Address:
| Address: | 625 S NEW BALLAS RD STE 2030 Saint Louis, MO 63141 |
| Phone Number: | 3142511700 |
| Fax Number: | 3142515804 |
Provider Business Practice Location Address:
| Address: | 625 S NEW BALLAS RD STE 2030 Saint Louis, MO 63141 |
| Phone Number: | 3142511700 |
| Fax Number: | 3142511701 |
Provider Taxonomy:
| Primary: | 207RC0000X |
| Secondary (if any): | |
| State: | MO |
