Individual
MRS. SAMANTHA ELIZABETH JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
132 PLYMOUTH CT, TROY, MO 63379-2994
(636) 698-5875
Mailing address
132 PLYMOUTH CT, TROY, MO 63379-2994
(636) 698-5875
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2021047772
MO
Other
Enumeration date
12/13/2021
Last updated
12/13/2021
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