Individual
DANYELL WYSINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
117 HAVEN ST, SAINT LOUIS, MO 63111-2921
(314) 326-1909
Mailing address
117 HAVEN ST, SAINT LOUIS, MO 63111-2921
(314) 326-1909
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
MO
Other
Enumeration date
03/08/2023
Last updated
03/08/2023
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