Individual
MRS. JETUAN L ROWLEY-HERRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Mailing address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-111984
IL
207Q00000X
Family Medicine Physician
Primary
2004020480
MO
207QS0010X
Sports Medicine (Family Medicine) Physician
036.111984
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036111984
—
IL
Enumeration date
12/23/2005
Last updated
12/30/2013
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