Individual
MRS. PRATHIBHA MANNIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5400 EXECUTIVE CENTRE PKWY, SAINT PETERS, MO 63376-2594
(636) 922-7600
Mailing address
1017 GOLDEN ORCHARD DR, O FALLON, MO 63368-7990
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2017008695
MO
Other
Enumeration date
05/17/2017
Last updated
05/17/2017
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