NPI 1730249079
United States Navy
Practice location
- Address
- 704 Guenevere Dr, Ballwin, MO 63011-3525
- Phone
- (636) 386-2729
- Fax
- (636) 527-8189
Authorised official
- Name
- Gary George Nitz
- Title
- Nurse Anesthetist
- Phone
- (314) 518-9118
Registered specialties
Operational (Transportable) Military General Acute Care Hospital
Primary
Registry record
- NPI
- 1730249079
- Entity type
- Organization
- NPI issued
- 9 Dec 2006
- Record last updated
- 22 Aug 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.