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Individual

RONALD C WILLEKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
4240 BLUE RIDGE BLVD, SUITE 515, KANSAS CITY, MO 64133-1713
(816) 353-0060
(816) 353-0070
Mailing address
4240 BLUE RIDGE BLVD, SUITE 515, KANSAS CITY, MO 64133-1713
(816) 353-0060
(816) 353-0070

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
115000
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
34345075
BCBS
MO
Enumeration date
06/05/2006
Last updated
10/12/2012
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