LAWRENCE WILFONG

SAINT LOUIS, MO
NPI1689187981
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: MO  000629)
Enumeration Date2017-11-08
Last Update Date2017-11-08
Business Address
LAWRENCE WILFONG COTA/L
3148 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63139-1118
Phone number: 314-664-4448
Mailing Address
LAWRENCE WILFONG COTA/L
3148 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63139-1118
Phone number:
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