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Individual

MARY PATRICIA GANLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
3470 HAMPTON AVE, SUITE 102, ST LOUIS, MO 63139-1936
(314) 352-6608
Mailing address
3470 HAMPTON AVE, SUITE 102, ST LOUIS, MO 63139-1936
(314) 352-6608

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
004365
MO

Other

Enumeration date
01/17/2007
Last updated
07/08/2007
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