Individual
LAURA M ENTWISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
524 W MADISON ST, BOLIVAR, MO 65613-1945
(417) 326-6284
(417) 326-6283
Mailing address
203 N BURTON AVE, SPRINGFIELD, MO 65802-2310
(417) 866-7818
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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