Individual
MR. EDWARD TIMOTHY ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
405 SAVANNAH RIDGE DR, SAINT CHARLES, MO 63303-2918
(636) 244-0704
(636) 244-0704
Mailing address
405 SAVANNAH RIDGE DR, SAINT CHARLES, MO 63303-2918
(636) 244-0704
(636) 244-0704
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
084580
MO
Other
Enumeration date
11/28/2011
Last updated
11/28/2011
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