Individual
MRS. LORI PENDERGRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
910 SPRINGFIELD RD, WILLOW SPRINGS, MO 65793
(417) 217-1811
Mailing address
PO BOX 392, WILLOW SPRINGS, MO 65793-0392
(417) 217-1811
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2013020044
MO
Other
Enumeration date
01/02/2014
Last updated
08/07/2020
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