Individual
MR. ROGER ALLEN REID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1714 W 16TH ST, SEDALIA, MO 65301-5273
(660) 827-1594
Mailing address
1714 W 16TH ST, SEDALIA, MO 65301-5273
(660) 827-1594
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2004003093
MO
Other
Enumeration date
06/27/2012
Last updated
06/27/2012
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