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Individual

LYDIA N. GREFFET

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4460 S LINDBERGH BLVD, SAINT LOUIS, MO 63127-1647
(314) 843-7557
(417) 269-2270
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(314) 843-7557
(314) 849-8671

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2017028633
PA STATE LICENSE
MO
Enumeration date
07/14/2017
Last updated
09/06/2023
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