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Organization

WAYNESVILLE PHYSICAL THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL TUPAS LAGUITAO PT (CHIEF OPERATING OFFICER)
(573) 528-1755
Entity
Organization

Contact information

Practice address
23675 ROSWELL LN, WAYNESVILLE, MO 65583-2738
(573) 774-5567
(573) 774-5567
Mailing address
23675 ROSWELL LN, WAYNESVILLE, MO 65583
(573) 774-5567
(573) 774-5567

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
02189
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
486647308
MO
Enumeration date
06/07/2013
Last updated
06/07/2013
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