DWAYNE E MAXAM

ST LOUIS, MO
NPI1285696401
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: MO  113728)
Enumeration Date2006-04-04
Last Update Date2007-07-08
Business Address
-- DWAYNE E MAXAM PT
3518 LACLEDE MARCHETTI EAST
ST LOUIS, MO 63103-2011
Phone number: 314-977-2323
Mailing Address
-- DWAYNE E MAXAM PT
3437 CAROLINE MALL
ST LOUIS, MO 63104-1111
Phone number: 314-977-8739
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