Individual
MRS. CAMILLE ELIZABETH BOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
106548
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106548
PHYSICAL THERAPY
MO
Enumeration date
09/24/2020
Last updated
01/15/2021
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