Individual
LISA FRAN ROLWES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11630 STUDT AVE STE 200, CREVE COEUR, MO 63141-7016
(314) 733-9100
Mailing address
11630 STUDT AVE STE 200, CREVE COEUR, MO 63141-7016
(314) 733-9100
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2006007771
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006007771
LICENSE NUMBER
MO
Enumeration date
10/28/2018
Last updated
06/11/2019
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