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Individual

KAYLA DAWN SPENCER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
202 MALLOY CIRCLE, DUENWEG, MO 64841
(417) 625-5275
Mailing address
310 W 8TH ST, JOPLIN, MO 64801-4302
(417) 625-5200

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2014025574
MO
2251P0200X
Pediatric Physical Therapist
2014025574
MO

Other

Enumeration date
08/01/2017
Last updated
08/01/2017
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