Individual
DEIDRA F COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1219 S MAIN ST, PALMYRA, MO 63461-1943
(573) 769-6166
(573) 769-2356
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-6200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2017003415
MO
Other
Enumeration date
12/15/2016
Last updated
01/20/2020
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