Individual
DR. JESSICA GRUBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10012 KENNERLY RD STE 401, SAINT LOUIS, MO 63128-2197
(314) 842-5660
Mailing address
10012 KENNERLY RD STE 401, SAINT LOUIS, MO 63128-2197
(314) 842-5660
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2017020337
MO
207N00000X
Dermatology Physician
2021022164
MO
Other
Enumeration date
06/21/2017
Last updated
11/17/2022
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