Individual
TERESA LOUISE SUESSEN I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
510 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63110-1016
(314) 362-2928
Mailing address
510 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63110-1016
(314) 362-2928
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
118356
MO
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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