Individual
MAURY ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1100 CLUB VILLAGE DR, SUITE 103, COLUMBIA, MO 65203-4409
(573) 256-2777
(573) 256-2764
Mailing address
1100 CLUB VILLAGE DR, SUITE 103, COLUMBIA, MO 65203-4409
(573) 256-2777
(573) 256-2764
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2000174328
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
485883813
—
MO
Enumeration date
09/13/2006
Last updated
09/17/2014
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