| Bluetail Biologics LLC | |
|
17300 N Outer 40 Rd Ste 201 Chesterfield MO 63005-1364 | |
| (636) 778-2900 | |
| (636) 778-2828 |
| Full Name | Bluetail Biologics LLC |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 17300 N Outer 40 Rd Ste 201, Chesterfield, Missouri |
| Authorized Official Name and Position | Joe Oneil (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 6367782826 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluetail Biologics LLC 17300 N Outer 40 Rd Ste 201 Chesterfield MO 63005-1364 Ph: (636) 778-2900 | Bluetail Biologics LLC 17300 N Outer 40 Rd Ste 201 Chesterfield MO 63005-1364 Ph: (636) 778-2900 |
| NPI Number | 1639645070 |
|---|---|
| Provider Enumeration Date | 10/23/2018 |
| Last Update Date | 10/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639645070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | () | Primary |
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