Individual
MISTY DACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1076 S ENGLISH AVE, MARSHALL, MO 65340-2614
(660) 815-2463
Mailing address
1076 S ENGLISH AVE, MARSHALL, MO 65340-2614
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2012004322
MO
Other
Enumeration date
07/27/2012
Last updated
07/27/2012
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