Individual
DEAN PESTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1266 E REPUBLIC RD, SPRINGFIELD, MO 65804-7209
(417) 882-1000
Mailing address
1266 E REPUBLIC RD, SPRINGFIELD, MO 65804-7209
(417) 882-1000
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2012023296
MO
Other
Enumeration date
03/27/2017
Last updated
03/27/2017
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