Individual
GRACIE E FIAONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
109 N KEENE ST, COLUMBIA, MO 65201-6725
(573) 443-2007
Mailing address
432 SOUTHAMPTON DR APT 2, COLUMBIA, MO 65203-3061
(573) 453-4155
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2017036518
MO
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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