Individual
MISS ABIGAIL GUIRNELA FORTICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
105 PLAZA DR, APT F, SIKESTON, MO 63801-5136
(646) 207-7869
Mailing address
214 W 5TH ST, SUITE D AND E, JOPLIN, MO 64801-2501
(646) 207-7869
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2006034872
MO
Other
Enumeration date
03/02/2008
Last updated
03/02/2008
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