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1699300087
CARLEY JOHNAH DYKSTRA
SAINT LOUIS, MO
NPI
1699300087
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Former Name
CARLEY JOHNAH SEROWOKY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MO 2020000655)
Enumeration Date
2020-03-06
Last Update Date
2020-03-06
Business Address
CARLEY JOHNAH DYKSTRA PA-C
9556 MANCHESTER RD
SAINT LOUIS, MO 63119-1313
Phone number: 314-961-2295
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Mailing Address
CARLEY JOHNAH DYKSTRA PA-C
103 APPLEGATE LN APT C
BALLWIN, MO 63011-3225
Phone number: 248-904-5173
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