Individual
JAQUELINE A BODKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
700 BIRCH LN, WAYNESVILLE, MO 65583-2275
(573) 774-6456
(573) 774-6778
Mailing address
2230 HIGHWAY 17, IBERIA, MO 65486-9216
(573) 774-6456
(573) 774-6778
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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