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Individual

MS. JODY L STANTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC, ATC

Contact information

Practice address
3555 S NATIONAL AVE, SPRINGFIELD, MO 65807-7310
(000) 000-0000
Mailing address
PO BOX 505673, SAINT LOUIS, MO 63150-5673
(417) 730-6430
(417) 269-7567

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
113614
MO

Other

Enumeration date
07/29/2005
Last updated
10/04/2024
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