Provider Information for 1205570488
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MICHELLE POINDEXTER
Sex: Female
NPI: 1205570488
Last Updated: 2024-04-02
Certification Date: 2024-04-02
Certification Date: 2024-04-02
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1205570488 | ||||||||||||
| Enumeration Date | 2022-04-25 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 3309 S KINGSHIGHWAY BLVD SAINT LOUIS, MO 63139-1101 United States Phone: 561-460-8420 | Fax: | ||||||||||||
| Primary Practice Address | 3309 S KINGSHIGHWAY BLVD SAINT LOUIS, MO 63139-1101 United States Phone: 561-460-8420 | Fax: | ||||||||||||
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