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MR. TIMOTHY JACK STANSBURY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.T. (R)

Contact information

Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
57 PEARL DR, HILLSBORO, MO 63050-5032
(636) 797-5983

Taxonomy

Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
376828
MO

Other

Enumeration date
12/31/2007
Last updated
12/31/2007
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