Individual
MR. CHARLES EDGAR AVERILL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.T.R. L.
Contact information
Practice address
704A SOUTH MISSOURI, MACON, MO 63552
(660) 385-2500
Mailing address
74 MANOR CREST DR, KIRKSVILLE, MO 63501-3356
(660) 627-2260
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2006013588
MO
Other
Enumeration date
11/13/2006
Last updated
07/08/2007
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