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1114954559
ANNE A. IDICULLA
SAINT JOSEPH, MO
NPI
1114954559
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Former Name
ANNE J. THOMAS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: MO 2001010866)
Enumeration Date
2006-06-28
Last Update Date
2017-10-06
Business Address
ANNE A. IDICULLA M.D.
802 N RIVERSIDE RD SUITE 260
SAINT JOSEPH, MO 64507-9794
Phone number: 816-271-7673
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Mailing Address
ANNE A. IDICULLA M.D.
802 N RIVERSIDE RD SUITE 130
SAINT JOSEPH, MO 64507-2502
Phone number: 816-271-7673
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