# ACTIVE CARE PHYSICAL THERAPY & SPINE CENTER, LLC

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

## Provider details

- **NPI number:** 1952362352
- **Authorized official:** MR. MICHAEL L MCCLAUGHRY P T (PARTNER)
- **Authorized official phone:** (573) 302-1288

## Contact information

- **Practice address:** 5497A HIGHWAY 54, OSAGE BEACH, MO 65065-3026
- **Practice address phone:** (573) 302-1288
- **Practice address fax:** (573) 302-1384
- **Mailing address:** 5497A HIGHWAY 54, OSAGE BEACH, MO 65065-3026
- **Mailing address phone:** (573) 302-1288
- **Mailing address fax:** (573) 302-1384

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 102576 | MO | Yes |

## Other

- **Enumeration date:** 03/28/2006
- **Last updated:** 08/22/2020