Individual
JESSICA LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
300 FLOYD DR, SIKESTON, MO 63801-3960
(573) 472-0397
(573) 472-0409
Mailing address
PO BOX 608, SIKESTON, MO 63801-0608
(573) 472-0397
(573) 472-0409
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2016030368
MO
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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