Individual
BAMBI HAVERSTICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 N MILL ST, FESTUS, MO 63028-1816
(636) 232-2323
Mailing address
227 MAIN ST, FESTUS, MO 63028-1952
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
113255
MO
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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