Individual
STACY MARIE BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
2015022475
MO
225200000X
Physical Therapy Assistant
Primary
2015024275
MO
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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