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General NPI Number Information
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NPI Number | 1184357949
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Entity Type | Individual
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Provider Name | ALLISON CASEY JUSSEL ZAGST OD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2022
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Last Update Date | 07/07/2022
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Provider Practice Location Address
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Address Line | 7840 NATURAL BRIDGE RD
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City | SAINT LOUIS
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State | MO
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Zip | 63121-4617
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Country | US
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Telephone | 314-516-5131
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Fax |
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Provider Business Mailing Address
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Address Line | 657 W FRISCO AVE
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City | WEBSTER GROVES
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State | MO
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Zip | 63119-3513
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Country | US
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Telephone | 512-484-9994
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2022019440
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License Number State | MO
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