Organization
BACK 2 LIFE HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERMILA MARIE CANNON LPN (OWNER)
(314) 276-9225
Entity
Organization
Contact information
Practice address
9645 LILLY JEAN DR, SAINT LOUIS, MO 63134-4236
(314) 276-9225
Mailing address
9645 LILLY JEAN DR, SAINT LOUIS, MO 63134-4236
(314) 276-9225
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
04/14/2021
Last updated
04/14/2021
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