Individual
MRS. JODY LYNN DISHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, NCTMB
Contact information
Practice address
109 W. WALL ST., STURGEON, MO 65284
(573) 687-2246
Mailing address
11204 AUDRAIN ROAD 973, CENTRALIA, MO 65240-6431
(573) 721-5547
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2004033293
MO
Other
Enumeration date
01/22/2007
Last updated
12/27/2010
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