Individual
MRS. EDITH MARCIA SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
800 S WHITE OAK RD, MARSHFIELD, MO 65706-2231
(417) 468-2890
Mailing address
800 S WHITE OAK RD, MARSHFIELD, MO 65706-2231
(918) 961-1162
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
002548
MO
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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