Organization · NPI-2

Florissant Valley Surgical Specialists

Colon & Rectal Surgery · Saint Louis, MO

NPI number1790876027
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1790876027
Entity type
Organization (NPI-2)
Legal business name
Florissant Valley Surgical Specialists
Organization subpart
No
Enumeration date
Sep 28, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208C00000X Colon & Rectal Surgery105535MOYes

Practice location

11125 Dunn Rd
Suite 402
Saint Louis, MO 63136-6132

Phone 314-741-3400

Mailing address

11125 Dunn Rd
Suite 402
Saint Louis, MO 63136-6132

Authorized official

Morin Hanson
Owner
3147413400

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