Individual
KATIE LYNN FAILS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, ATC
Contact information
Practice address
4331 S FREMONT AVE, SPRINGFIELD, MO 65804-7328
(417) 820-5010
Mailing address
4331 S FREMONT AVE, SPRINGFIELD, MO 65804-7328
(417) 820-5010
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2012023500
MO
2255A2300X
Athletic Trainer
Primary
2012011128
MO
Other
Enumeration date
08/03/2012
Last updated
08/03/2012
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