Organization · NPI-2

Affirmed Family Healthcare, LLC

Family Medicine · Saint Louis, MO

NPI number1629135108
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1629135108
Entity type
Organization (NPI-2)
Legal business name
Affirmed Family Healthcare, LLC
Organization subpart
No
Enumeration date
Jan 3, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine2004001454MOYes

Practice location

3645 Oakmount Ave
Saint Louis, MO 63121-4906

Phone 314-383-0330 · Fax 314-383-0510

Mailing address

3645 Oakmount Ave
Saint Louis, MO 63121-4906

Phone 314-383-0330 · Fax 314-383-0510

Authorized official

Laurain Carroll Hendricks
Physician-Owner
3143953575

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