Individual
DR. JACQUELINE LEVY REISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1570 WOODLAKE DR, CHESTERFIELD, MO 63017-5712
(314) 878-0996
Mailing address
1570 WOODLAKE DR, CHESTERFIELD, MO 63017-5712
(314) 878-0996
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
MDR4P58
MO
Other
Enumeration date
08/30/2005
Last updated
07/08/2007
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