Individual
JOANN MACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1432 SOUTHWEST BLVD, JEFFERSON CITY, MO 65109
(573) 632-5660
(573) 632-5859
Mailing address
1432 SOUTHWEST BLVD, CAPITAL REGION REHABILITATION SPECIALISTS, JEFFERSON CITY, MO 65109
(573) 632-5660
(573) 632-5859
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2000169335
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001013325
MEDICARE
—
01
—
131574
BLUE CROSS BLUE SHIELD
—
01
—
1860598
FIRST HEALTH
—
05
—
205096803
—
MO
01
—
250012149
RR MEDICARE
—
01
—
441613
HEALTHLINK
—
01
—
6033757
CIGNA
—
01
—
E55013
MERCY
—
Enumeration date
03/14/2006
Last updated
06/30/2009
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