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1518587658
CHARLENE WATERS
SAINT LOUIS, MO
NPI
1518587658
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: MO 2019027412)
Enumeration Date
2020-04-18
Last Update Date
2020-04-18
Business Address
CHARLENE WATERS PTA
615 S NEW BALLAS RD
SAINT LOUIS, MO 63141-8221
Phone number: 636-388-1707
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Mailing Address
CHARLENE WATERS PTA
3337 EMINENCE BLVD
SAINT LOUIS, MO 63114-4219
Phone number: 636-388-1707
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