Individual provider · NPI-1

Jackie R Goostree

Specialist/Technologist, Other, Surgical Technologist · Saint Peters, MO

NPI number1275774077
StatusActive
Last updated in NPPESMar 9, 2009

Details

NPI
1275774077
Entity type
Individual (NPI-1)
Name
Jackie R Goostree
Sex
Female
Sole proprietor
No
Enumeration date
Mar 9, 2009
Last updated
Mar 9, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
246ZS0410X Specialist/Technologist, Other, Surgical Technologist––Yes

Practice location

5401 Veterans Memorial Pkwy Ste 100
Saint Peters, MO 63376-1681

Phone 636-441-0906 · Fax 636-928-9288

Mailing address

20 Parkview Dr
Saint Peters, MO 63376-2919

Phone 636-441-0906 · Fax 636-928-9288

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