Individual
MR. RONALD A VAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
2021 S WAVERLY AVE STE 300, SPRINGFIELD, MO 65804-2417
(417) 886-8881
Mailing address
2021 S WAVERLY AVE STE 300, SPRINGFIELD, MO 65804-2417
(417) 886-8881
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
02674
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31440
BLUECROSS BLUESHIELD
MO
Enumeration date
08/25/2006
Last updated
07/09/2007
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