Individual
STANLEY MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1500 PARK AVE, SAINT LOUIS, MO 63104-3024
(214) 778-9299
Mailing address
2862 WOODBURY DR, SAINT LOUIS, MO 63125-5124
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/12/2025
Last updated
05/19/2025
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