Individual
WHITNEY MARIE WITHERSPOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3821 VAILE AVE, FLORISSANT, MO 63034-2227
(314) 438-7176
Mailing address
3821 VAILE AVE, FLORISSANT, MO 63034-2227
(314) 736-4112
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
2013036768
MO
Other
Enumeration date
02/23/2018
Last updated
02/23/2018
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