Individual
LISA MAISCH BRENNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3520 CHOUTEAU AVE, SAINT LOUIS, MO 63103-2916
(314) 771-2100
Mailing address
805 WALNUT DR, COLUMBIA, IL 62236-2055
(618) 281-6538
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
117973
MO
Other
Enumeration date
06/13/2007
Last updated
07/08/2007
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