Individual
ADRAIN GILLISPIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11140 OLD SAINT CHARLES RD, SAINT ANN, MO 63074-2113
(314) 429-6949
Mailing address
11140 OLD ST. CHARLES ROCK RD., ST. LOUIS, MO 63074
(314) 429-6949
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431811807
—
MO
Enumeration date
04/14/2010
Last updated
04/14/2010
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