Individual
LYDIA LUISA ARCHULETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
901 E 5TH ST, WASHINGTON, MO 63090-3127
(636) 239-8000
Mailing address
901 E 5TH ST, WASHINGTON, MO 63090-3127
(636) 239-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2019030489
MO
Other
Enumeration date
05/04/2016
Last updated
09/18/2019
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