Individual
JAC RANDALL DORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1948 E CHESAPEAKE DR, OZARK, MO 65721-7815
(417) 551-3210
(888) 527-0428
Mailing address
6104 N 27TH ST, OZARK, MO 65721-5857
(417) 838-1701
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
R1148
MO
Other
Enumeration date
10/07/2009
Last updated
10/07/2009
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