Individual
BOBBY DEWAIN PROCELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
2133 W MELBOURNE CT, SPRINGFIELD, MO 65810-1909
(417) 882-5416
Mailing address
2133 W MELBOURNE CT, SPRINGFIELD, MO 65810-1909
(417) 882-5416
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
004232
MO
Other
Enumeration date
03/21/2008
Last updated
03/21/2008
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