Individual
JOHNCY D DUFRESNE
Active
Individual
JOHNCY D DUFRESNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
107192
MO
225100000X
Physical Therapist
11-02145
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33541051
BCBS-KC
—
01
—
738395
OPTUM
—
01
—
KA2868054
MEDICARE PTAN
KS
01
—
MA43700035
MEDICARE PTAN
MO
Enumeration date
08/08/2006
Last updated
06/03/2014
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