Individual
MRS. DEBORAH IBORG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3400 PERSHALL RD, SAINT LOUIS, MO 63135-1408
(314) 513-4285
Mailing address
14 CHANDLER CT, SAINT CHARLES, MO 63303-5340
(314) 513-4285
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
00047
MO
Other
Enumeration date
02/21/2006
Last updated
07/08/2007
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