Individual
MR. GEORGE FULLER CHERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A. CCC-SLP
Contact information
Practice address
1100 N KENTUCKY AVE, WEST PLAINS, MO 65775-2029
(417) 257-5959
Mailing address
RR 2 BOX 592, AVA, MO 65608-9643
(417) 683-4469
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
102596
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
468868625
—
MO
Enumeration date
07/29/2008
Last updated
07/29/2008
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