Individual
JEFFREY WADE WOMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
914 CHICKESAW ST, SENECA, MO 64865-9281
(417) 776-8041
Mailing address
1623 KINGSBURY AVE, MIAMI, OK 74354-2180
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2018007364
MO
225100000X
Physical Therapist
2513
OK
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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