Organization
LAKE ST. LOUIS WIGS AND CUTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN HOUSEWRIGHT (PRESIDENT)
(636) 887-2193
Entity
Organization
Contact information
Practice address
950 CORPORATE PKWY STE 100, WENTZVILLE, MO 63385-4851
(636) 887-2193
Mailing address
950 CORPORATE PKWY STE 100, WENTZVILLE, MO 63385-4851
(636) 887-2193
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
09/18/2020
Last updated
09/18/2020
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