Individual
JACOB KIRTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6420 CLAYTON RD, RICHMOND HEIGHTS, MO 63117-1811
(314) 768-8000
Mailing address
7839 NAVAJOE ST, SAINT LOUIS, MO 63123-2754
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
123786
MO
Other
Enumeration date
04/10/2019
Last updated
04/10/2019
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