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Individual

MRS. EMILY RENEE GROZDANIC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
2454 W CLAY ST, SAINT CHARLES, MO 63301-2548
(636) 949-3926
Mailing address
5353A DEVONSHIRE AVE, SAINT LOUIS, MO 63109-2305
(314) 488-0438

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2010023045
MO

Other

Enumeration date
06/26/2012
Last updated
06/26/2012
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