Individual
SPENCER BLONDEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12409 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2507
(636) 429-0999
Mailing address
5219 WILSON AVE, SAINT LOUIS, MO 63110-3137
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/15/2022
Last updated
06/19/2024
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