Individual
RICHEL PINGKIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
710 BROADRIDGE DR, JACKSON, MO 63755
(573) 243-4704
Mailing address
680 E JEFFERSON ST, JACKSON, MO 63755-2296
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2004003754
MO
Other
Enumeration date
11/09/2007
Last updated
11/09/2007
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