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Individual

KENNEDY MARIE ISAAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
621 S NEW BALLAS RD STE 63B, SAINT LOUIS, MO 63141-8251
(314) 960-8771
Mailing address
3 INWOOD CT, SAINT PETERS, MO 63376-2613

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2023014817
MO

Other

Enumeration date
01/04/2022
Last updated
04/01/2024
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