STACEY E BROUK

SAINT LOUIS, MO
NPI1558511048
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: MO  2008030030)
Enumeration Date2008-09-22
Last Update Date2012-10-04
Business Address
-- STACEY E BROUK RD, LD
10007 KENNERLY RD SUITE A
SAINT LOUIS, MO 63128-2179
Phone number: 314-776-7112
Mailing Address
-- STACEY E BROUK RD, LD
PO BOX 29255
SAINT LOUIS, MO 63126-0255
Phone number: 314-776-7112
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