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1164761946
LISA REQUENA
BRANSON, MO
NPI
1164761946
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MO 2018014210)
Enumeration Date
2013-02-13
Last Update Date
2019-05-13
Business Address
Dr. LISA REQUENA D.O.
525 BRANSON LANDING BLVD
BRANSON, MO 65616-2052
Phone number: 417-348-8646
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Mailing Address
Dr. LISA REQUENA D.O.
PO BOX 4046
SPRINGFIELD, MO 65808-4046
Phone number: 417-269-7241
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