Organization
FREDERICKTOWN R-I SCHOOL DIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY A BURLISON (SUPERINTENDENT)
(573) 783-2570
Entity
Organization
Contact information
Practice address
704 E HIGHWAY 72, FREDERICKTOWN, MO 63645-7491
(573) 783-2570
(573) 783-7045
Mailing address
704 E HIGHWAY 72, FREDERICKTOWN, MO 63645-7491
(573) 783-2570
(573) 783-7045
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
506076207
—
MO
Enumeration date
02/08/2007
Last updated
11/09/2009
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