Individual
TERESA WILLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 N MAIN ST, MOUNT VERNON, MO 65712-1004
(417) 466-4000
Mailing address
4898 LAWRENCE 1225, ASH GROVE, MO 65604-7278
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
2011037859
MO
Other
Enumeration date
03/02/2015
Last updated
03/02/2015
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