Individual
MRS. LEOTA R MAAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CDE
Contact information
Practice address
1432 SOUTHWEST BLVD, JEFFERSON CITY, MO 65109-2444
(573) 632-5092
(573) 632-5857
Mailing address
1432 SOUTHWEST BLVD, PO BOX 1128, JEFFERSON CITY, MO 65109-2444
(573) 632-5092
(573) 632-5857
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
086461
MO
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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