Organization
LIAISON HEALTH GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WOGENE AMSALU (NURSE PRACTITIONER)
(314) 779-6022
Entity
Organization
Contact information
Practice address
9628 MIDLAND BLVD, OVERLAND, MO 63114-3357
(314) 779-6022
Mailing address
9628 MIDLAND BLVD, OVERLAND, MO 63114-3357
(314) 779-6022
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018001284
BOARD OF NURSING
MO
Enumeration date
11/06/2021
Last updated
01/13/2023
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