Individual
VENUS FORTIN PENULIAR-CHUPUICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
1238 COMMERCIAL ST, WARSAW, MO 65355-3157
(660) 438-2876
Mailing address
611 E OAK ST, CLINTON, MO 64735-1671
(417) 396-6371
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2005036212
MO
Other
Enumeration date
01/24/2010
Last updated
01/24/2010
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