# WILLARD PHYSICAL THERAPY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528737780
- **Authorized official:** KALA DANIELLE SHEPPARD PT, DPT, ATC (DR.)
- **Authorized official phone:** (417) 221-4667

## Contact information

- **Practice address:** 304 E JACKSON ST \# 2F, WILLARD, MO 65781-9333
- **Practice address phone:** (417) 827-9153
- **Mailing address:** PO BOX 257, WILLARD, MO 65781-0257
- **Mailing address phone:** (417) 221-4667
- **Mailing address fax:** (417) 744-9674

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/10/2021
- **Last updated:** 01/17/2022