Individual
MARLENE WURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1565 STE GENEVIEVE AVE, FARMINGTON, MO 63640
(573) 756-5749
Mailing address
PO BOX 459, FARMINGTON, MO 63640-0459
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
110533
MO
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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