Individual
SARAH AGNES ECK WALTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
701 S NEW BALLAS RD STE 510, SAINT LOUIS, MO 63141-8726
(314) 251-6710
(314) 251-6712
Mailing address
701 S NEW BALLAS RD STE 510, SAINT LOUIS, MO 63141-8726
(314) 251-6710
(314) 251-6712
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2015012056
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015012056
PA LICENSE
MO
05
—
220024387
—
MO
Enumeration date
05/04/2015
Last updated
02/04/2026
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