Individual
MAKAYLA WITZIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
12680 OLIVE BLVD, SAINT LOUIS, MO 63141-6289
(314) 251-8888
(314) 251-8889
Mailing address
12680 OLIVE BLVD STE 300, SAINT LOUIS, MO 63141-6322
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2025023161
MO
Other
Enumeration date
04/09/2025
Last updated
08/15/2025
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