Individual
LAURA GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
103 E NURSERY, BUTLER, MO 64730-9309
(660) 679-3179
Mailing address
ROUTE 1 BOX 149, SCHELL CITY, MO 64783
(417) 432-3537
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
115388
MO
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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