Organization
MISSOURI STATE UNIVERSITY PT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL VERE HALLIDAY PT (CLINIC DIRECTOR)
(417) 836-3070
Entity
Organization
Contact information
Practice address
606 E CHERRY ST, ROOM 100, SPRINGFIELD, MO 65806-3401
(417) 836-3070
Mailing address
901 S NATIONAL AVE, SPRINGFIELD, MO 65897-0027
(417) 836-3070
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/11/2006
Last updated
08/22/2020
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