Individual
SHANE DYLAN STROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3437 CAROLINE ST, SAINT LOUIS, MO 63104-1111
(314) 977-2570
Mailing address
5641 N MAGNOLIA AVE, SAINT LOUIS, MO 63139-1639
(636) 541-8924
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/08/2021
Last updated
01/08/2021
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