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General NPI Number Information
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NPI Number | 1497019889
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Entity Type | Individual
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Provider Name | PRATISTHA STRONG DO
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Gender | Female
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Dates
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Enumeration Date | 06/29/2012
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Last Update Date | 09/20/2019
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Provider Practice Location Address
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Address Line | 10807 BIG BEND RD STE 1
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City | KIRKWOOD
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State | MO
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Zip | 63122-6054
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Country | US
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Telephone | 918-814-3996
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Fax | 432-614-2599
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Provider Business Mailing Address
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Address Line | 10807 BIG BEND RD STE 1
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City | KIRKWOOD
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State | MO
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Zip | 63122-6054
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Country | US
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Telephone | 918-814-3996
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Fax | 432-614-2599
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 2018020028
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License Number State | MO
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