Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 0103301084 | VA |
NPI | 1053623058 |
---|---|
Provider Name | Dr. Camille Patrice Ryans |
First Address | Saint Louis, MO 63146 |
Second Address | Saint Louis, MO 63146-1973 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2010 |
Last Update Date | 18/02/2016 |