Organization
DIXON REORGANIZED DIST R1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON EASTERLING (DISTRICT COORDINATOR)
(573) 759-7163
Entity
Organization
Contact information
Practice address
106 W FOURTH ST, DIXON, MO 65459-0166
(573) 759-7163
(573) 759-2506
Mailing address
PO BOX A, 106 W FOURTH STREET, DIXON, MO 65459-0166
(573) 759-7163
(573) 759-2506
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
506075308
—
MO
Enumeration date
02/07/2007
Last updated
06/13/2016
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