Individual
TABATHA MARIE STABLER SAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10 PROFESSIONAL PARK DR, MARYVILLE, IL 62062-5672
(618) 288-7244
Mailing address
6810 STATE ROUTE 162 STE 215, MARYVILLE, IL 62062-8566
(618) 391-6495
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085.008911
IL
Other
Enumeration date
01/08/2021
Last updated
03/09/2022
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