| Twmk2 | |
|
7396 Pershing Ave Saint Louis MO 63130-4206 | |
| (773) 672-2342 | |
| (773) 825-8219 |
| Full Name | Twmk2 |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7396 Pershing Ave, Saint Louis, Missouri |
| Authorized Official Name and Position | Travis Wood Munnerlyn (OWNER/PRESIDENT) |
| Authorized Official Contact | 7736770937 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Twmk2 451 Alice Ave Kirkwood MO 63122-6304 Ph: (773) 677-0937 | Twmk2 7396 Pershing Ave Saint Louis MO 63130-4206 Ph: (773) 672-2342 |
| NPI Number | 1205512969 |
|---|---|
| Provider Enumeration Date | 06/26/2023 |
| Last Update Date | 06/26/2023 |
| Certification Date | 06/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205512969 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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