Individual
PAMELA JEAN UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 MEDICAL PLZ, LAKE ST LOUIS, MO 63367-1366
(636) 625-7734
Mailing address
300 PIONEER RIDGE DR, WENTZVILLE, MO 63385-4472
(636) 327-7357
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2001019230
MO
Other
Enumeration date
03/16/2012
Last updated
03/16/2012
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