HIENOK HAILU

SAINT LOUIS, MO
NPI1144775966
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: MO  2016015067)
Enumeration Date2016-08-22
Last Update Date2016-08-29
Business Address
-- HIENOK HAILU
11725 CASA GRANDE DR
SAINT LOUIS, MO 63146-4223
Phone number: 314-255-8395
Mailing Address
-- HIENOK HAILU
11725 CASA GRANDE DR
SAINT LOUIS, MO 63146-4223
Phone number: 314-255-8395
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