Individual
EMILY THERESE BOECKENSTEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3437 CAROLINE ST, SAINT LOUIS, MO 63104-1111
(314) 977-8505
Mailing address
1517 CLARKSON CT, NAPERVILLE, IL 60565-1733
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.008887
IL
Other
Enumeration date
01/08/2021
Last updated
02/24/2022
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