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Individual

MR. MICHAEL TUPAS LAGUITAO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
2107 HISTORIC RTE. 66 WEST, APT. #2, WAYNESVILLE, MO 65583-2442
(573) 774-4125
Mailing address
2107 HISTORIC RTE. 66 WEST, APT. #2, WAYNESVILLE, MO 65583-2442
(573) 774-4125

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02189
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02189
MO. PT LICENSE
MO
01
05003954A
PT LICENSE
IN
01
PT11828
PT LICENSE
FL
Enumeration date
09/25/2007
Last updated
09/25/2007
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