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1093241564
JAQUAN VASSEL
SAINT LOUIS, MO
NPI
1093241564
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224L00000X Pedorthist
(Licence: MO CPED4300)
Enumeration Date
2017-05-03
Last Update Date
2017-05-03
Business Address
-- JAQUAN VASSEL C.PED, BOCPD
7150 NATURAL BRIDGE RD
SAINT LOUIS, MO 63121-5151
Phone number: 314-381-8600
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Mailing Address
-- JAQUAN VASSEL C.PED, BOCPD
7150 NATURAL BRIDGE RD
SAINT LOUIS, MO 63121-5151
Phone number: 314-381-8600
Copy
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