Individual
MISS CLARISSE DAWN BALBONTIN GEMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
214 W 5TH ST, JOPLIN, MO 64801-2501
(417) 782-2917
Mailing address
2001 CONNECTICUT AVE APT D2, JOPLIN, MO 64804-1100
(417) 659-9656
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.016649
IL
Other
Enumeration date
01/28/2009
Last updated
01/28/2009
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