Individual
MORRIS DEMOIN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
4422 THUNDERBOLT DR, SCOTT AFB, IL 62225-6301
(253) 468-2087
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.126744
IL
164W00000X
Licensed Practical Nurse
48498
SC
Other
Enumeration date
09/25/2019
Last updated
09/25/2019
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