Individual
KAITLYN MICHELLE WALTSGOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7437 WATSON RD, SAINT LOUIS, MO 63119-4415
(314) 687-1215
Mailing address
867 W 4TH ST, AVISTON, IL 62216-3459
(618) 616-7202
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2023046729
MO
Other
Enumeration date
11/29/2023
Last updated
11/29/2023
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