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Individual

LESLIE CARR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
2017 W WOODLAND ST, SPRINGFIELD, MO 65807-5913
(417) 889-4800
Mailing address
PO BOX 9163, SPRINGFIELD, MO 65801-9163

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2016027208
PHYSICAL THERAPY LICENSE
MO
Enumeration date
07/25/2019
Last updated
07/25/2019
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