Individual
LISA WAECKERLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
201 S KIRKWOOD RD, KIRKWOOD, MO 63122-4305
(314) 984-9220
(314) 984-9225
Mailing address
201 S KIRKWOOD RD, KIRKWOOD, MO 63122-4305
(314) 984-9220
(314) 984-9225
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01077
MO
Other
Enumeration date
07/22/2010
Last updated
07/22/2010
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