Individual
DENNISE STAAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5616 W NORVELL BRYANT HWY, CRYSTAL RIVER, FL 34429-7572
(352) 795-1999
Mailing address
918 HILLCREST RD, ROCHESTER, IL 62563-9223
(217) 341-2423
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/18/2015
Last updated
06/18/2015
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