Individual
JORDAN NICHOL PUVOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
102 S FORREST AVE, LIBERTY, MO 64068-1908
(816) 429-5199
(816) 429-7129
Mailing address
102 S FORREST AVE, LIBERTY, MO 64068-1908
(816) 429-5199
(816) 429-7129
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2022030907
MO
Other
Enumeration date
08/09/2022
Last updated
08/09/2022
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