Individual
LISA CHESNUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
16216 BAXTER RD STE 330, CHESTERFIELD, MO 63017-4778
(636) 733-3330
(636) 733-3332
Mailing address
16216 BAXTER RD STE 330, CHESTERFIELD, MO 63017-4778
(636) 733-3330
(636) 733-3332
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2003011554
MO
Other
Enumeration date
12/12/2011
Last updated
12/12/2011
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