Individual
MR. MARK AINSWORTH PABARUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3812 KENTUCKY DERBY DR, FLORISSANT, MO 63034-3322
(314) 659-6342
Mailing address
3812 KENTUCKY DERBY DR, FLORISSANT, MO 63034-3322
(314) 659-6342
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
10/01/2012
Last updated
10/01/2012
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