Individual
BRIAN MICHAEL LAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1020 S PARKWAY ST, CAPE GIRARDEAU, MO 63703-7704
(573) 270-7985
Mailing address
931 LAKE ST, JACKSON, MO 63755-2629
(573) 270-7985
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2005006165
MO
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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