Individual
DANIELLE BRIANNA WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPY
Contact information
Practice address
872 COLLEGE BLVD, OSAGE BEACH, MO 65065-8408
(573) 302-0900
Mailing address
1103 W LINE ST, PALMYRA, MO 63461-1827
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2015039522
MO
Other
Enumeration date
01/09/2018
Last updated
10/13/2022
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