Individual
CASSIDY BROOKE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10012 KENNERLY RD STE 406, SAINT LOUIS, MO 63128-2197
(314) 525-1224
Mailing address
568 COUNTY ROAD 4222, POPLAR BLUFF, MO 63901-8047
(573) 718-8939
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2024007403
MO
Other
Enumeration date
01/26/2024
Last updated
05/09/2024
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