Individual provider · Type 1 NPI

Michael Boswell Diffley

Student in an Organized Health Care Education/Training Program · St. Louis, MO

NPI number 1871097998 Active

Practice location

1402 S Grand Blvd # M260
St. Louis, MO 63104-1004

Call (817) 713-4646 Map

Mailing address

2211 Spanish Trl
Fort Worth, TX 76107-3579

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1871097998

Michael Boswell Diffley's National Provider Identifier is 1871097998, issued on Mar 22, 2018. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in St. Louis, MO. The record was last updated on Mar 22, 2018.