| Ozark Neuro Rehab Center | |
|
3550 S National Ave Suite 200 Springfield MO 65807-7309 | |
| (417) 269-9300 | |
| (417) 269-0582 |
| Full Name | Ozark Neuro Rehab Center |
|---|---|
| Speciality | Psychologist |
| Location | 3550 S National Ave, Springfield, Missouri |
| Authorized Official Name and Position | Robert T. Brodhead (PRESIDENT) |
| Authorized Official Contact | 4178202000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ozark Neuro Rehab Center 3550 S National Ave Suite 200 Springfield MO 65807-7309 Ph: (417) 269-9300 | Ozark Neuro Rehab Center 3550 S National Ave Suite 200 Springfield MO 65807-7309 Ph: (417) 269-9300 |
| NPI Number | 1427157999 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1658321377 |
|---|---|
| Medicare Enrollment ID | O20080304000146 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427157999 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2006010348 (Missouri) | Primary |
| Provider Name | Michael M Whetstone |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306843735 PECOS PAC ID: 8325109226 Enrollment ID: I20081210000811 |
| Provider Name | Bralin Lee Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154081461 PECOS PAC ID: 5698145548 Enrollment ID: I20230110002342 |
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