Individual
MR. LUIS L SACLOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2525 S MARKET ST, SUITE #100, ROGERS, AR 72758-8163
(479) 770-5655
(479) 770-5656
Mailing address
841 FRANCIS AVE, NEOSHO, MO 64850-9186
(417) 455-9435
(479) 770-5656
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
AR1655
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105315
MO PT LICENSE
MO
01
—
AR1655
STATE LICENSE #: AR1655
AR
Enumeration date
08/14/2008
Last updated
03/07/2017
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