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1831185651
DIANE LOUISE LIGHT
JEFFERSON CITY, MO
NPI
1831185651
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208600000X Surgery
(Licence: MO 100575)
Enumeration Date
2005-09-27
Last Update Date
2012-08-10
Business Address
-- DIANE LOUISE LIGHT D.O.
1125 MADISON ST
JEFFERSON CITY, MO 65101-5227
Phone number: 573-632-5700
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Mailing Address
-- DIANE LOUISE LIGHT D.O.
1125 MADISON ST PO BOX 1107
JEFFERSON CITY, MO 65101-5227
Phone number: 573-632-5700
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