Individual
MRS. SAMANTHA L VISSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
126 MISSOURI AVE, BOX 1227, FORT LEONARD WOOD, MO 65473-8952
(573) 596-3150
(573) 596-0407
Mailing address
126 MISSOURI AVE, BOX 1227, FORT LEONARD WOOD, MO 65473-8952
(573) 596-3150
(573) 596-0407
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2004006253
MO
Other
Enumeration date
08/26/2010
Last updated
08/26/2010
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