Organization
SIMPELO MEDI-SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSTICO VILLANUEVA SIMPELO M.D. (OWNER)
(573) 436-1200
Entity
Organization
Contact information
Practice address
25 SOUTHTOWNE DR, POTOSI, MO 63664-5729
(573) 436-1200
Mailing address
25 SOUTHTOWNE DR, POTOSI, MO 63664-5729
(573) 436-1200
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LC0879401
MO
Other
Enumeration date
03/24/2008
Last updated
03/24/2008
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