Individual
MRS. VIRGINIA DIANNE GRAYUM-SCHULTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
14014 MANCHESTER ROAD, BALLWIN, MO 63011-4514
(636) 391-0015
(636) 391-0015
Mailing address
14014 MANCHESTER ROAD, BALLWIN, MO 63011-4514
(636) 391-0015
(636) 391-0015
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
2003005687
MO
Other
Enumeration date
10/27/2011
Last updated
10/27/2011
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