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Individual

GORDON BERNERD TSUBIRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
2321 S PATTERSON AVE, JOPLIN, MO 64804-2464
(417) 551-3806
Mailing address
2321 S PATTERSON AVE, JOPLIN, MO 64804-2464
(417) 551-3806

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
076103
IA
225X00000X
Occupational Therapist
Primary
2019045933
MO

Other

Enumeration date
01/02/2019
Last updated
05/05/2026
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