Individual
DR. JOHN RICHARD FONTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD.
Contact information
Practice address
1400 STATE ROAD F, WAYNESVILLE, MO 65583-2831
(573) 774-0097
(573) 774-0096
Mailing address
1400 STATE ROAD F, WAYNESVILLE, MO 65583-2831
(573) 774-0097
(573) 774-0096
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
01169
MO
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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