Individual
MR. ROB EDWARD LIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1712 LINE AVE, ROLLA, MO 65401-9620
(573) 578-6121
Mailing address
1712 LINE AVE, ROLLA, MO 65401-9620
(573) 578-6121
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
116304
MO
Other
Enumeration date
08/29/2013
Last updated
08/29/2013
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