Individual
JOHN M FENTON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
838 RACHEL ST, REPUBLIC, MO 65738-1721
(417) 732-8483
(417) 732-8902
Mailing address
838 RACHEL ST, REPUBLIC, MO 65738-1721
(417) 732-8483
(417) 732-8902
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
12/02/2011
Last updated
12/02/2011
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