Individual
MARY WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
895 RUE SAINT FRANCOIS, FLORISSANT, MO 63031-4923
(314) 921-3366
Mailing address
895 RUE SAINT FRANCOIS, FLORISSANT, MO 63031-4923
(314) 921-3366
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
2007002923
MO
Other
Enumeration date
05/31/2016
Last updated
06/02/2016
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