NPI 1093241564

Jaquan Vassel, CPEDBOCPD

Practitioner Pedorthist Saint Louis, MO

Practice location

Address: 7150 Natural Bridge Rd, Saint Louis, MO 63121-5151
Phone: (314) 381-8600
Fax: (314) 381-6844

Registered specialties

Pedorthist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224L00000X Licence CPED4300 (MO)

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Registry record

NPI: 1093241564
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 May 2017
Record last updated: 3 May 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.