| |
1050 W 10th St Rolla MO 65401-2905 | |
(573) 458-3431 | |
(573) 458-3433 |
Full Name | |
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Speciality | Physical Medicine & Rehabilitation |
Location | 1050 W 10th St, Rolla, Missouri |
Authorized Official Name and Position | John Denbo (CEO) |
Authorized Official Contact | 5734588899 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 579 Rolla MO 65402-0579 Ph: (314) 989-0300 | 1050 W 10th St Rolla MO 65401-2905 Ph: (573) 458-3431 |
NPI Number | 1508056540 |
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Provider Enumeration Date | 07/26/2007 |
Last Update Date | 05/01/2023 |
Identifier | Type | State | Issuer |
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1508056540 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Primary |
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