JAQUAN VASSEL

SAINT LOUIS, MO
NPI1093241564
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224L00000X 
(Licence: MO  CPED4300)
Enumeration Date2017-05-03
Last Update Date2017-05-03
Business Address
-- JAQUAN VASSEL C.PED, BOCPD
7150 NATURAL BRIDGE RD
SAINT LOUIS, MO 63121-5151
Phone number: 314-381-8600
Mailing Address
-- JAQUAN VASSEL C.PED, BOCPD
7150 NATURAL BRIDGE RD
SAINT LOUIS, MO 63121-5151
Phone number: 314-381-8600
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