Individual
MR. JOHN SANTILLANA LARDIZABAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
214 W 5TH ST, JOPLIN, MO 64801-2501
(417) 782-2917
(417) 782-7038
Mailing address
214 W 5TH ST, JOPLIN, MO 64801-2501
(417) 782-2917
(417) 782-7038
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070016860
IL
Other
Enumeration date
01/05/2009
Last updated
01/05/2009
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