| |
108 S Main St, Vandalia, MO 63382-1806 | |
(573) 594-2520 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Physical Therapist |
Location | 108 S Main St, Vandalia, Missouri |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1467696104 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 2005040393 (Missouri) | Primary |
Mailing Address | Practice Location Address |
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407 Yale St, Mexico, MO 65265-2340 Ph: (573) 582-7129 | 108 S Main St, Vandalia, MO 63382-1806 Ph: (573) 594-2520 |