Individual
MANFREDO FLORESCRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 EAST FIFITH STREET, FULTON, MO 65251
(573) 592-2030
Mailing address
600 EAST FIFITH STREET, FULTON, MO 65251
(573) 592-2030
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2023049778
MO
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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