Individual
JILL WIDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
893 FAIRWAY DR, CHILLICOTHE, MO 64601-3673
(660) 200-6620
Mailing address
212 ELM ST, CHILLICOTHE, MO 64601-2733
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2011022994
MO
Other
Enumeration date
07/29/2013
Last updated
07/29/2013
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