Individual
CLIFFE OBANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14600 MONDOUBLEAU LN, FLORISSANT, MO 63034-2314
(202) 378-4864
Mailing address
14600 MONDOUBLEAU LN, FLORISSANT, MO 63034-2314
(202) 378-4864
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
342000000X
Transportation Network Company
Primary
—
—
Other
Enumeration date
04/19/2022
Last updated
04/19/2022
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