# DYNAMIC PHYSICAL THERAPY & SPORTS PERFORMANCE LLC

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

## Provider details

- **NPI number:** 1750603106
- **Authorized official:** BRAD BOYD (CEO)
- **Authorized official phone:** (417) 859-3991

## Contact information

- **Practice address:** 1350 SPUR DR STE 180, MARSHFIELD, MO 65706-2190
- **Practice address phone:** (417) 859-3991
- **Practice address fax:** (417) 859-0100
- **Mailing address:** PO BOX 1497, OZARK, MO 65721-1497
- **Mailing address phone:** (417) 859-3991
- **Mailing address fax:** (417) 859-0100

## Taxonomy

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

## Other

- **Enumeration date:** 02/25/2010
- **Last updated:** 11/06/2019