Individual
MRS. SANDRA LASAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1 VILLAGE SQ STE A, HAZELWOOD, MO 63042-1817
(314) 731-4555
(314) 551-6110
Mailing address
1 VILLAGE SQ STE A, HAZELWOOD, MO 63042-1817
(314) 731-4555
(314) 551-6110
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
107653
MO
Other
Enumeration date
07/28/2010
Last updated
07/28/2010
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