Individual
ROBERT CZARNECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
402 N KEENE ST, SUITE 101, COLUMBIA, MO 65201-6986
(573) 874-0001
Mailing address
215 HAAF DR, JEFFERSON CITY, MO 65101-4411
(573) 874-0001
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
20050307589
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005037589
LICENSE #
MO
Enumeration date
08/30/2006
Last updated
07/08/2007
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