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Individual

RACHEL PETROV

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3165 MCKELVEY RD STE 200, BRIDGETON, MO 63044-2550
(314) 206-3900
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2009015947
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2009015947
RN
MO
Enumeration date
12/16/2017
Last updated
12/16/2017
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