Individual
JULIA DAFFORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12255 DEPAUL DRIVE, STE 705, BRIDGETON, MO 63044
(314) 344-7545
Mailing address
138 HEMSTEAD ST, LAKE BLUFF, IL 60044-1155
(760) 662-1292
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
213ES0103X
MO
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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