Organization
VASSEL'S LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAQUAN VASSEL C.PED, BOCPD (OWNER/HEAD PEDORTHIST)
(314) 885-0359
Entity
Organization
Contact information
Practice address
10421 W FLORISSANT AVE, SAINT LOUIS, MO 63136-2342
(314) 885-0359
Mailing address
10421 W FLORISSANT AVE, SAINT LOUIS, MO 63136-2342
(314) 885-0359
(314) 474-0208
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
—
—
Other
Enumeration date
04/02/2019
Last updated
11/27/2023
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