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Individual

MRS. MARILYN ANN WEBER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPTA

Contact information

Practice address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 454-6154
Mailing address
3317 HOFFMANN LN, FULTS, IL 62244-1355
(618) 458-7195

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
117326
MO

Other

Enumeration date
10/30/2012
Last updated
10/30/2012
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