Individual
MRS. KATHYREN MARIE SOUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1910 NURSING HOME RD, OWENSVILLE, MO 65066-2844
(573) 437-4101
Mailing address
3456 KLEMME RD, GERALD, MO 63037-1727
(573) 219-6177
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2007023630
MO
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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