Individual
OLIVIA JECKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 PORTLAND ST, COLUMBIA, MO 65201-6521
(573) 884-6052
Mailing address
205 PORTLAND ST, COLUMBIA, MO 65201-6521
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
RBT-21-171650
MO
Other
Enumeration date
10/28/2021
Last updated
10/28/2021
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