Search › Missouri › 2255A2300X
Justin Ullom
NPI 1538626007 · on the registry since 2019
Practice
- Address
- 1111 Victor St
Saint Louis, MO 63104 - Phone
- (636) 236-5756
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Also registered as
- 2255A2300X
390200000X - Licence states on file
- MO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-04-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri