| Excelsia Mo, Llc | |
|
4434 S Lindbergh Blvd Saint Louis MO 63127-1647 | |
| (410) 933-5678 | |
| Not Available |
| Full Name | Excelsia Mo, Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 4434 S Lindbergh Blvd, Saint Louis, Missouri |
| Authorized Official Name and Position | John Wall (CHIEF LEGAL OFFICER) |
| Authorized Official Contact | 4124965959 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Excelsia Mo, Llc 9601 Pulaski Park Dr Ste 417 Middle River MD 21220-1409 Ph: () - | Excelsia Mo, Llc 4434 S Lindbergh Blvd Saint Louis MO 63127-1647 Ph: (410) 933-5678 |
| NPI Number | 1447026141 |
|---|---|
| Provider Enumeration Date | 12/04/2023 |
| Last Update Date | 01/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447026141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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