Individual
MRS. LORI LEANNE SOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
500 N MEDICAL DR, ASH GROVE, MO 65604-1005
(417) 751-2575
Mailing address
7789 N STATE HIGHWAY V, ASH GROVE, MO 65604-8840
(417) 751-3117
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2001023613
MO
Other
Enumeration date
08/18/2009
Last updated
08/18/2009
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