Individual
PAUL DENNIS PUTT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
A.T., C.
Contact information
Practice address
1317 E REPUBLIC RD, SPRINGFIELD, MO 65804-7204
(417) 889-4411
Mailing address
1317 E REPUBLIC RD, SPRINGFIELD, MO 65804-7204
(417) 889-4411
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
109936
MO
Other
Enumeration date
09/06/2005
Last updated
07/08/2007
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