Individual
JAGABANDHU HALDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
3038 W TRUMAN BLVD, JEFFERSON CITY, MO 65109-0525
(573) 893-3404
Mailing address
121 PALISADES DR, JEFFERSON CITY, MO 65109-6182
(573) 893-4274
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2004024069
MO
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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