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Individual

MR. MICHAEL T HIMMELMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
225 PHYSICIANS PARK, SUITE 101, POPLAR BLUFF, MO 63901-3956
(573) 778-9348
(573) 686-4870
Mailing address
2725 N WESTWOOD BLVD, SUITE 17, POPLAR BLUFF, MO 63901-2346
(573) 686-4277
(573) 686-4406

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2011037087
MO
225100000X
Physical Therapist
PT2966
AR
2251S0007X
Sports Physical Therapist
2011037087
2251S0007X
Sports Physical Therapist
PT2966
AR
2251X0800X
Orthopedic Physical Therapist
2011037087
2251X0800X
Orthopedic Physical Therapist
PT2966
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
164036721
AR
Enumeration date
05/17/2007
Last updated
10/29/2013
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