Individual
ISAAC A SOUTHWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
172 DARE BLVD, CAMDENTON, MO 65020-5558
(573) 346-9213
Mailing address
160 MISTY MEADOWS DRIVE, CAMDENTON, MO 65020
(573) 480-0261
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
2022038148
MO
Other
Enumeration date
01/05/2024
Last updated
01/05/2024
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