Individual
PATRICE EDORA HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 GREENWAY MANOR, FLORISSANT, MO 63033
(314) 838-2393
(314) 838-2616
Mailing address
500 GREENWAY MANOR, FLORISSANT, MO 63033
(314) 838-2393
(314) 838-2616
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374U00000X
—
MO
Enumeration date
05/21/2019
Last updated
05/21/2019
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