Individual
BRYAN HATHCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
100 MEDICAL DR., ALTON, MO 65606
(417) 778-7227
(417) 778-7225
Mailing address
100 MEDICAL DR., ALTON, MO 65606
(417) 778-7227
(417) 778-7225
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2018026101
MO
Other
Enumeration date
03/25/2020
Last updated
03/25/2020
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