Individual
BLENDI MULLALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 977-1676
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/14/2021
Last updated
02/15/2022
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