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Individual

JUDY CLAYTON-WIESE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
5649 SOUTHWEST AVE, SAINT LOUIS, MO 63139-1650
(314) 250-2812
Mailing address
5649 SOUTHWEST AVE, SAINT LOUIS, MO 63139-1650
(314) 250-2812

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
123887
MO

Other

Enumeration date
11/26/2016
Last updated
11/26/2016
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