Individual
BRIAN SCOTT MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
276 FOUNTAIN LN, KIMBERLING CITY, MO 65686-9356
(417) 739-2481
Mailing address
276 FOUNTAIN LN, KIMBERLING CITY, MO 65686-9356
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2001026581
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2001026581
PHYSICAL THERAPIST ASSISTANT LICENSE
MO
Enumeration date
08/21/2008
Last updated
08/21/2008
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