Lake Girl, INC
NPI #1255730446 in House Springs, Missouri
Provider Information
- NPI Number
- 1255730446
- Entity Type
- Organization
- Organization Name
- Lake Girl, INC
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Aug 14, 2014
- Last Updated
- Dec 21, 2023
Practice Location
- Address
- 4581 GRAVOIS RD
- City
- House Springs
- State
- Missouri
- ZIP Code
- 63051-1374
- Phone
- (636) 671-9980
Authorized Official
- Name
- MRS. RENEE L WILLER, APRN
- Title
- OWNER
- Phone
- (314) 322-7017
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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