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STACEY NICOLE HUMPHREY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2175 ORLEANS LN, FLORISSANT, MO 63031-2111
(314) 243-1785
(314) 480-7162
Mailing address
2175 ORLEANS LN, FLORISSANT, MO 63031-2111
(314) 243-1785
(314) 480-7162

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary

Other

Enumeration date
03/04/2016
Last updated
02/05/2020
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