Individual
MR. GONZALO REMULLA II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
750 W COOPER ST, BUFFALO, MO 65622-8662
(417) 345-5413
(417) 345-8674
Mailing address
1500 N OAKLAND AVE, BOLIVAR, MO 65613-3011
(417) 328-6252
(417) 328-6242
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2005000219
MO
Other
Enumeration date
09/19/2007
Last updated
09/19/2007
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