Stacy Wisdom

NPI #1194297416 in Festus, Missouri

Provider Information

NPI Number
1194297416
Entity Type
Individual
Name
Stacy Wisdom
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Technician
Enumeration Date
Dec 27, 2018
Last Updated
Dec 27, 2018

Practice Location

Address
227 MAIN ST
City
Festus
ZIP Code
63028-1952
Phone
(636) 931-2700

Specialties & Taxonomy Codes

Specialty
Technician

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