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Individual

JOHN SOI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2700 E 34TH ST, JOPLIN, MO 64804-4310
(417) 781-1737
Mailing address
722 W 4TH ST, WEBB CITY, MO 64870-2108

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2016008662
MO

Other

Enumeration date
01/24/2017
Last updated
01/24/2017
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