Individual
KODI BYRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
711 VETERANS MEMORIAL PKWY STE 202, SAINT CHARLES, MO 63303-2106
(636) 669-2345
Mailing address
125 SUNRISE DR, JACKSON, MO 63755-7772
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2020004343
MO
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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