Individual
MS. BRANDY MELISA DALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
300 FLOYD DR, SIKESTON, MO 63801-3960
(573) 472-0397
(573) 472-0409
Mailing address
1307 HOLLY DR, CAPE GIRARDEAU, MO 63701-2154
(573) 808-4748
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1999135026
MO
Other
Enumeration date
09/22/2006
Last updated
07/09/2007
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