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1750653697
LISA PORTHOUSE
SAINT LOUIS, MO
NPI
1750653697
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
367A00000X Advanced Practice Midwife
(Licence: MO 113826)
Enumeration Date
2012-02-08
Last Update Date
2013-06-24
Business Address
LISA PORTHOUSE CNM
621 S NEW BALLAS RD SUITE 2009 B
SAINT LOUIS, MO 63141-8232
Phone number: 314-251-6000
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Mailing Address
LISA PORTHOUSE CNM
621 S NEW BALLAS RD SUITE 2009 B
SAINT LOUIS, MO 63141-8232
Phone number: 314-251-6000
Copy
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