# LAKE ST. LOUIS WIGS AND CUTS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659987295
- **Authorized official:** SUSAN HOUSEWRIGHT (PRESIDENT)
- **Authorized official phone:** (636) 887-2193

## Contact information

- **Practice address:** 950 CORPORATE PKWY STE 100, WENTZVILLE, MO 63385-4851
- **Practice address phone:** (636) 887-2193
- **Mailing address:** 950 CORPORATE PKWY STE 100, WENTZVILLE, MO 63385-4851
- **Mailing address phone:** (636) 887-2193

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 224P00000X | Prosthetist | — | — | Yes |

## Other

- **Enumeration date:** 09/18/2020
- **Last updated:** 09/18/2020