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Individual

PHILLIP WAYNE GOBLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, CHT

Contact information

Practice address
1423 N JEFFERSON AVE, SPRINGFIELD, MO 65802-1917
(417) 269-3177
Mailing address
1423 N JEFFERSON AVE, SPRINGFIELD, MO 65802-1988
(417) 269-3177
(417) 269-3789

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
104630
MO

Other

Enumeration date
04/14/2020
Last updated
04/14/2020
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