Individual
MR. TOM L. HARTLINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LP
Contact information
Practice address
1271 S SALT POND AVE, MARSHALL, MO 65340-3040
(660) 886-9479
Mailing address
1271 S SALT POND AVE, MARSHALL, MO 65340-3040
(660) 886-9479
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
01591
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CDA3990289
CTS-CONTRACT MANAGEMENT
MO
Enumeration date
03/27/2007
Last updated
07/08/2007
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