Individual
MISS ROXANNE CARANDANG RECEDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2639 E 5TH ST, JOPLIN, MO 64801-1637
(417) 553-0651
Mailing address
2639 E 5TH ST, JOPLIN, MO 64801-1637
(417) 553-0651
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT- 3606
HI
Other
Enumeration date
03/26/2013
Last updated
03/26/2013
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