Individual
DONALD POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
372 NE SHALE LN, SPICKARD, MO 64679-7292
(660) 485-6125
Mailing address
372 NE SHALE LN, SPICKARD, MO 64679-7292
(660) 485-6125
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
12/05/2012
Last updated
12/05/2012
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