Individual
MRS. OCTAVIA LOUISE MCQUITTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OCTAVIA
Contact information
Practice address
504 ROCHEPORT ST, FAYETTE, MO 65248-1290
(660) 888-0669
Mailing address
504 ROCHEPORT ST, FAYETTE, MO 65248-1290
(660) 888-0669
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
NONE
—
Other
Enumeration date
08/18/2019
Last updated
08/18/2019
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