Individual
MRS. MYRIA MARLENE BOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3800 S NATIONAL AVE STE LL100, SPRINGFIELD, MO 65807-5276
(417) 269-7784
(417) 269-6721
Mailing address
PO BOX 505673, SAINT LOUIS, MO 63150-5673
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2019004683
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220073150
—
MO
Enumeration date
02/07/2019
Last updated
04/16/2024
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