Individual
STEPHANIE KONRADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1015 PARKFIELD TER, MANCHESTER, MO 63021-6811
(314) 578-1959
Mailing address
1015 PARKFIELD TER, MANCHESTER, MO 63021-6811
(314) 578-1959
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2000155596
MO
Other
Enumeration date
02/07/2007
Last updated
07/09/2007
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