Individual
LANDON HOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3915 WATSON RD, SAINT LOUIS, MO 63109-1267
(314) 881-0300
Mailing address
2 BROADWAY VILLAGE DR APT F, COLUMBIA, MO 65201-8673
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2021006394
MO
Other
Enumeration date
03/30/2020
Last updated
06/22/2021
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