Individual
RICKE DALE CALLICOAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2133 NW 13TH ST, BLUE SPRINGS, MO 64015-7734
(816) 224-0003
(816) 224-2199
Mailing address
24789 WILDLIFE DR, WARSAW, MO 65355-3751
(816) 956-1640
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
MO
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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