Individual
DR. KAYLEA MARIE BOUTWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14825 N OUTER 40 RD, SUITE 360, CHESTERFIELD, MO 63017-2152
(314) 336-2570
(314) 336-2571
Mailing address
14825 N OUTER 40 RD, SUITE 360, CHESTERFIELD, MO 63017-2152
(314) 336-2570
(314) 336-2571
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2009025407
MO
208VP0014X
Interventional Pain Medicine Physician
Primary
2009025407
MO
Other
Enumeration date
06/20/2007
Last updated
11/24/2009
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