Individual
CORBIN JON DEWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4396 W DELMAR ST, SPRINGFIELD, MO 65802-7809
(417) 501-8213
(417) 501-8213
Mailing address
1606 N PINE ST, NIXA, MO 65714-8704
(417) 247-1809
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/25/2025
Last updated
04/15/2025
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