Individual
MR. JEREMY RYAN SKEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1200 N MAIN ST STE 1, MOUNTAIN GROVE, MO 65711-1025
(417) 926-5699
(417) 926-5703
Mailing address
2596 PINE RIDGE LANE, MOUNTAIN GROVE, MO 65711
(417) 962-0034
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2001017159
MO
Other
Enumeration date
08/11/2006
Last updated
07/09/2007
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