Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CEOO5641 | MO |
NPI | 1154448124 |
---|---|
Provider Name | Dr. Gail Williams Cloud |
First Address | Olivette, MO 63132-3017 |
Second Address | Olivette, MO 63132-3017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 08/07/2007 |