Individual
PRENTISS BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11553 CARAWAY CT, SAINT LOUIS, MO 63138-2405
(314) 575-3275
Mailing address
11553 CARAWAY CT, SAINT LOUIS, MO 63138-2405
(314) 575-3275
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
LC014475474
MO
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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