Individual
ANGELA GRAINGER GAUTHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1050 OLD DES PERES RD, SUITE 100, SAINT LOUIS, MO 63131-1873
(314) 569-0612
(314) 569-0618
Mailing address
1050 OLD DES PERES RD STE 100, SAINT LOUIS, MO 63131-1873
(314) 569-0612
(314) 569-0618
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2014004341
MO
363A00000X
Physician Assistant
—
CO
Other
Enumeration date
02/21/2014
Last updated
01/28/2026
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