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4201 Highway K O'fallon MO 63368-8230 | |
(314) 961-2255 | |
(314) 270-3694 |
Full Name | |
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Speciality | Clinic/center |
Location | 4201 Highway K, O'fallon, Missouri |
Authorized Official Name and Position | Troy Adam Dinkel (OWNER) |
Authorized Official Contact | 3149612255 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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9556 Manchester Rd Saint Louis MO 63119-1313 Ph: (314) 961-2255 | 4201 Highway K O'fallon MO 63368-8230 Ph: (314) 961-2255 |
NPI Number | 1952853889 |
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Provider Enumeration Date | 10/26/2016 |
Last Update Date | 07/28/2024 |
Identifier | Type | State | Issuer |
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1952853889 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 2005029371 (Missouri) | Primary |