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Individual

MS. TAWANA SPANN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, MS, GCS

Contact information

Practice address
4934 BERTHOLD AVE, SAINT LOUIS, MO 63110-1408
(314) 363-4078
(314) 652-1881
Mailing address
4934 BERTHOLD AVE, SAINT LOUIS, MO 63110-1408
(314) 363-4078
(314) 652-1881

Taxonomy

Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
070012762
IL
2251G0304X
Geriatric Physical Therapist
Primary
112062
MO

Other

Enumeration date
12/12/2011
Last updated
12/12/2011
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