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Individual

MR. ARCHIE R. WINNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
3216 EMERALD LN, SUITE A, JEFFERSON CITY, MO 65109-6947
(573) 636-6400
Mailing address
3216 EMERALD LN, SUITE A, JEFFERSON CITY, MO 65109-6947
(573) 636-6400

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2009035745
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2009035745
STATE LICENSE NUMBER
MO
Enumeration date
11/28/2011
Last updated
03/08/2013
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