Individual
MRS. PAMELA VANTRICE ROYSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MO HEALTH NET PROVID
Contact information
Practice address
11581 W FLORISSANT AVE, FLORISSANT, MO 63033-6740
(314) 664-5155
(866) 255-9006
Mailing address
11581 W FLORISSANT AVE, FLORISSANT, MO 63033-6740
(314) 664-5155
(866) 255-9006
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/28/2018
Last updated
12/28/2018
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