Individual
LATRICIA DALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4130 SEVEN HILLS DR, FLORISSANT, MO 63033-6708
(314) 972-0409
Mailing address
4130 SEVEN HILLS DR, FLORISSANT, MO 63033-6708
(314) 972-0409
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2005015259
MO
Other
Enumeration date
07/07/2011
Last updated
07/07/2011
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