SearchMissouri163WH0200X

Tommie Dale

NPI 1861995136 · on the registry since 2018

Practice

Address
3834 Kentucky Derby Dr
Florissant, MO 63034
Phone
(314) 276-8596

Registry record

Primary taxonomy
163WH0200X
163WH0200X
Licence states on file
MO
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2018-03-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri