Individual
LISA BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 BROOKES DR, HAZELWOOD, MO 63042-2736
(314) 494-4055
Mailing address
320 BROOKES DR, HAZELWOOD, MO 63042-2736
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
05/31/2012
Last updated
05/31/2012
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