| Visionary Cts Llc | |
|
1551 Wall St Ste 120 Saint Charles MO 63303-3540 | |
| (636) 219-0177 | |
| (636) 493-1002 |
| Full Name | Visionary Cts Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1551 Wall St Ste 120, Saint Charles, Missouri |
| Authorized Official Name and Position | Bradley A Breeden (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9136699394 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Visionary Cts Llc 1551 Wall St Ste 120 Saint Charles MO 63303-3540 Ph: (636) 219-0177 | Visionary Cts Llc 1551 Wall St Ste 120 Saint Charles MO 63303-3540 Ph: (636) 219-0177 |
| NPI Number | 1073198065 |
|---|---|
| Provider Enumeration Date | 03/11/2021 |
| Last Update Date | 03/11/2021 |
| Medicare PECOS PAC ID | 1951717099 |
|---|---|
| Medicare Enrollment ID | O20210315002359 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073198065 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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