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General NPI Number Information
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NPI Number | 1760009575
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Entity Type | Individual
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Provider Name | SIMONE MCGARY
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Gender | Female
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Dates
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Enumeration Date | 06/26/2020
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Last Update Date | 03/17/2021
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Provider Practice Location Address
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Address Line | 9378 OLIVE BLVD STE 306
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City | OLIVETTE
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State | MO
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Zip | 63132-3215
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Country | US
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Telephone | 816-721-3327
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Fax |
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Provider Business Mailing Address
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Address Line | 2480 LAMPONG DR APT 100C
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City | SAINT LOUIS
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State | MO
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Zip | 63125-3145
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Country | US
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Telephone | 816-721-3327
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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 | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State | MO
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