Doctor Name: | MRS. ALLISON GRACE TUTTLE |
NPI Number: | 1053359281 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 2006006981 |
Business Practice Address: | 615 S. New Ballas Rd Mercy Hospital St. Louis St. Louis, MO - 63141 |
Business Phone Number: | 3142516000 |
Business Fax Number: | |
Mailing Address: | 621 S. New Ballas Rd., Midwest Spine Surgeons ST. LOUIS |
State: | MO |
Postal Code: | 63141 |
Phone Number: | 3142513990 |
Fax Number: | |
NPI Enumeration Date: | 06/02/2006 |
NPI Last Update Date: | 12/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 2006006981 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |