Individual
MARIO MILLSAP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3144 LACKLAND AVE, SAINT LOUIS, MO 63116-2020
(314) 200-5486
Mailing address
3144 LACKLAND AVE, SAINT LOUIS, MO 63116-2020
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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