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Individual

KATHY RAVEN MYRICK-KASPRZAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CMT

Contact information

Practice address
400 N MAIN ST STE 200, ROLLA, MO 65401-3000
(573) 458-5357
(573) 458-5357
Mailing address
400 N MAIN ST STE 200, ROLLA, MO 65401-3000
(573) 458-5357
(573) 458-5357

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
2005026107
MO

Other

Enumeration date
02/09/2009
Last updated
02/09/2009
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