Individual
DR. JON PATRICK TALLERICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4411 E SUNSHINE ST STE H, SPRINGFIELD, MO 65809-2907
(417) 887-1350
Mailing address
723 S SPARKS AVE, SPRINGFIELD, MO 65802-2850
(417) 827-9035
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2023038583
MO
225700000X
Massage Therapist
2007004680
MO
Other
Enumeration date
09/26/2023
Last updated
12/04/2023
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