Jacob Lee Gunn, DPT | |
121 N Dean Ave, Raymore, MO 64083-8398 | |
(573) 823-5113 | |
Not Available |
Full Name | Jacob Lee Gunn |
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Gender | Male |
Speciality | Physical Therapist |
Location | 121 N Dean Ave, Raymore, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689430092 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 2024007036 (Missouri) | Primary |
Provider Name | Fit Muscle & Joint Clinic Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1801350921 PECOS PAC ID: 5991935579 Enrollment ID: O20221031002698 |
Mailing Address | Practice Location Address |
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Jacob Lee Gunn, DPT 121 N Dean Ave, Raymore, MO 64083-8398 Ph: () - | Jacob Lee Gunn, DPT 121 N Dean Ave, Raymore, MO 64083-8398 Ph: (573) 823-5113 |
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