Individual
CHANDLER REBECCA LEE MONGERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3800 S NATIONAL AVE STE 600, SPRINGFIELD, MO 65807-5249
(000) 000-0000
Mailing address
PO BOX 505673, SAINT LOUIS, MO 63150-5673
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2024005760
MO
Other
Enumeration date
02/15/2024
Last updated
03/25/2024
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