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SOPHIA CUSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6486
Mailing address
625 S NEW BALLAS RD STE 7020, SAINT LOUIS, MO 63141-8218
(314) 251-6486

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2015007863
MO

Other

Enumeration date
05/22/2015
Last updated
10/26/2021
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