Ridenour, Brock Davis
Ridenour, Brock Davis is an sole proprietor health care provider with primary practice located at 12460 Olive Blvd Suite 202, Saint Louis MO 63141-6409. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Ridenour, Brock Davis can be contacted via phone (314) 909-1202.Contact Information
Primary practice address
12460 Olive Blvd Suite 202
Saint Louis MO 63141-6409
Phone: (314) 909-1202
Fax: (314) 909-1290
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | 101951 | Missouri |
Profile Details
| NPI number | 1164536710 |
|---|---|
| LBN Legal business name | Ridenour, Brock Davis |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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