SHANNON MICHELLE ROOT BAST

BRIDGETON, MO
NPI1760946669
Former NameSHANNON ROOT
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: MO  2020023147)
Enumeration Date2019-01-24
Last Update Date2026-03-06
Business Address
SHANNON MICHELLE ROOT BAST PA
12266 DE PAUL DR STE 205
BRIDGETON, MO 63044-2514
Phone number: 314-218-2300
Mailing Address
SHANNON MICHELLE ROOT BAST PA
PO BOX 955534
SAINT LOUIS, MO 63195-0001
Phone number:
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