Individual
CASEY MARIE VERBANAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6000
Mailing address
71 OLD COUNTRY CT, LAKE SAINT LOUIS, MO 63367-5845
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2021051040
MO
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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