Individual
ENRIQUE DE LA PIEDRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
196 HWY 196, LINN, MO 65051-3500
(573) 897-0700
(573) 897-0400
Mailing address
196 HWY 196, LINN, MO 65051-3500
(573) 897-0700
(573) 897-0400
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
042107
MO
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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