Individual
JACKIE LEE HASSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5118 NEW MELLE OAKS LN, WENTZVILLE, MO 63385-6164
(636) 887-5876
Mailing address
5118 NEW MELLE OAKS LN, WENTZVILLE, MO 63385-6164
(636) 887-5876
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
118168
MO
Other
Enumeration date
04/14/2008
Last updated
03/26/2014
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