Individual
MRS. DONNA TIPTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1525 VILLA DR, DE SOTO, MO 63020-2586
(636) 931-5818
Mailing address
953 LEGENDS VIEW DR, EUREKA, MO 63025-3600
(636) 549-3677
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT102201
MO
Other
Enumeration date
02/08/2011
Last updated
02/08/2011
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