Individual
KATHY-JO FACTEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BC-HIS
Contact information
Practice address
1005 N PINE ST, ROLLA, MO 65401-2824
(573) 368-3242
Mailing address
PO BOX 519, SALEM, MO 65560-0519
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
001031
MO
Other
Enumeration date
06/08/2010
Last updated
06/08/2010
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