Iconic Services Inc

Sports Medicine (Family Medicine) Physician · Saint Louis, MO

Organization Active NPI

NPI number 1750872354

Practice location

4625 Lindell Blvd Ste 200
Saint Louis, MO 63108-3729
Phone
(314) 437-8932
Fax
(888) 749-2228

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NPI record

NPI
1750872354
Entity type
Organization (Type 2)
Enumeration date
May 21, 2018
Last updated
May 21, 2018
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Sports Medicine (Family Medicine) Physician Primary 207QS0010X — —

Authorized official

Name
Christine B Cordero
Title
Manager
Phone
(314) 437-8932

About Iconic Services Inc

Iconic Services Inc is a healthcare organization registered in the NPI registry with the primary taxonomy Sports Medicine (Family Medicine) Physician (code 207QS0010X). The practice location is 4625 Lindell Blvd Ste 200, Saint Louis, MO 63108-3729. The NPI number 1750872354 was assigned on May 21, 2018 and the record was last updated on May 21, 2018.

The authorized official for this organization is Christine B Cordero, Manager.

Frequently asked questions

What is the NPI number of Iconic Services Inc?

The NPI number is 1750872354.

What is the phone number of Iconic Services Inc?

The phone number listed for the practice location is (314) 437-8932.

Where is Iconic Services Inc located?

4625 Lindell Blvd Ste 200, Saint Louis, MO 63108-3729.

What is the taxonomy code for Iconic Services Inc?

The primary taxonomy code is 207QS0010X – Sports Medicine (Family Medicine) Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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