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Individual

MS. CALLIE COPPEDGE EMMART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHYSICAL THERAPIST

Contact information

Practice address
403 HWY 160 WEST, GAINESVILLE, MO 65655
(417) 679-4929
Mailing address
RR 3 BOX 147G, AVA, MO 65608-8107
(417) 683-0187

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2009005438
MO
2251G0304X
Geriatric Physical Therapist
2009005438
MO

Other

Enumeration date
07/17/2013
Last updated
07/17/2013
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