Individual
MISTY KAUFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
913 W BUSINESS US HIGHWAY 60, DEXTER, MO 63841-2704
(573) 624-6405
Mailing address
1104 WILDWOOD RD, DEXTER, MO 63841-2849
(573) 620-1192
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002016792
LICENSE #
MO
Enumeration date
08/30/2006
Last updated
07/08/2007
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