Individual
JENNIFER G FUNKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3381 KANELL BLVD, POPLAR BLUFF, MO 63901-3060
(573) 775-0761
(573) 785-0031
Mailing address
PO BOX 1064, POPLAR BLUFF, MO 63902-1064
(573) 778-9348
(573) 686-0178
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2003022299
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
486083702
—
MO
Enumeration date
04/25/2006
Last updated
08/20/2013
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