Individual
MRS. CONNIE PREWETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
126 MISSOURI AVE, BOX 1263, FORT LEONARD WOOD, MO 65473-8952
(573) 596-0048
(573) 596-0716
Mailing address
126 MISSOURI AVE, BOX 1263, FORT LEONARD WOOD, MO 65473-8952
(573) 596-0048
(573) 596-0716
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
08/26/2010
Last updated
08/26/2010
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