Individual
MARY STUART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 MEMORIAL DR, STE 130B, ALTON, IL 62002-6751
(618) 463-7600
(618) 463-7601
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(618) 463-7600
(618) 463-7601
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.004857
IL
Other
Enumeration date
02/24/2014
Last updated
02/28/2021
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