Individual
TIMOTHY STOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
793 CROSS CREEK DR, CREVE COEUR, MO 63141-6509
(314) 220-1017
Mailing address
793 CROSS CREEK DR, CREVE COEUR, MO 63141-6509
(314) 220-1017
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2014022032
MO
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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