Individual
JANE EVELYN MAYDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
88 MAIN ST, LOCKWOOD, MO 65682-9698
(417) 850-7734
Mailing address
88 MAIN ST, LOCKWOOD, MO 65682-9698
(417) 850-7734
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
R0830
MO
Other
Enumeration date
06/09/2020
Last updated
06/09/2020
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