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MRS. LEASA A MOORE SIMERLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1111 EUCLID AVE, CAMERON, MO 64429-2005
(816) 593-2176
Mailing address
22307 COUTY ROAD 243, UNION STAR, MO 64494
(816) 593-2176

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2000175354
MO

Other

Enumeration date
02/01/2012
Last updated
02/01/2012
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