Individual
JAQUAN VASSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.PED, BOCPD
Contact information
Practice address
7150 NATURAL BRIDGE RD, SAINT LOUIS, MO 63121-5151
(314) 381-8600
(314) 381-6844
Mailing address
7150 NATURAL BRIDGE RD, SAINT LOUIS, MO 63121-5151
(314) 381-8600
(314) 381-6844
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
CPED4300
MO
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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