Individual
GARY DEAN POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1207 COLBY DR, SAINT PETERS, MO 63376-5512
(314) 401-2531
Mailing address
1207 COLBY DR, SAINT PETERS, MO 63376-5512
(314) 401-2531
Taxonomy
Speciality
Code
Description
License number
State
246QL0900X
Laboratory Management Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
919983040
UNITED HEALTHCARE
MO
Enumeration date
11/23/2017
Last updated
11/23/2017
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