Individual
DEANNA MARIE NORDWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
711 E JACKSON ST, MEXICO, MO 65265-2903
(573) 582-8888
(573) 582-3774
Mailing address
7627 AUDRAIN ROAD 355, MEXICO, MO 65265-5804
(573) 721-3308
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2013026824
MO
Other
Enumeration date
08/18/2013
Last updated
08/18/2013
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