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Individual

MISS GRACE AGNUS LEHOUILLIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1096 TOM GINNEVER AVE, O FALLON, MO 63366-4519
(636) 978-5255
Mailing address
1096 TOM GINNEVER AVE, O FALLON, MO 63366-4519
(636) 978-9255

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2018026138
MO

Other

Enumeration date
01/03/2019
Last updated
01/03/2019
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