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NPI Profile for PENNIE D CLINTON in SAINT LOUIS, MO.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Community Health |
163WC1500X |
| NPI Number | 1912248758 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 03/04/2013 | |
| Last updated | 03/04/2013 - About 13 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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PENNIE D CLINTON
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PENNIE D CLINTON