Individual
STACY BEQUETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1817 SPOTTED OWL DR, IMPERIAL, MO 63052-4402
(573) 465-6038
Mailing address
1817 SPOTTED OWL DR, IMPERIAL, MO 63052-4402
(573) 465-6038
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
11/23/2018
Last updated
11/23/2018
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