Individual
LACRISHA WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2665 GRAVOIS AVE, SAINT LOUIS, MO 63118-1543
(314) 922-6398
Mailing address
3002 S JEFFERSON AVE, SAINT LOUIS, MO 63118-1513
(314) 991-1495
(314) 881-1400
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
371586570
MO
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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