Individual
THERESA CANNES MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4444 FOREST PARK AVE STE 120, SAINT LOUIS, MO 63108-2212
(314) 286-1495
(314) 286-1473
Mailing address
4444 FOREST PARK AVE STE 120, SAINT LOUIS, MO 63108-2212
(314) 286-1495
(314) 286-1473
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
117610
MO
Other
Enumeration date
05/28/2019
Last updated
05/28/2019
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