Individual
MARGARET M CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13861 MANCHESTER RD, BALLWIN, MO 63011-4503
(636) 932-8029
Mailing address
2164 AVALON VIEW DR, FENTON, MO 63026-2692
(314) 277-8075
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2022012581
MO
Other
Enumeration date
04/08/2022
Last updated
04/11/2022
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