Organization
ACTIVE CARE PHYSICAL THERAPY & SPINE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL L MCCLAUGHRY P T (PARTNER)
(573) 302-1288
Entity
Organization
Contact information
Practice address
5497A HIGHWAY 54, OSAGE BEACH, MO 65065-3026
(573) 302-1288
(573) 302-1384
Mailing address
5497A HIGHWAY 54, OSAGE BEACH, MO 65065-3026
(573) 302-1288
(573) 302-1384
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
102576
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
189021
BLUE CROSS
MO
Enumeration date
03/28/2006
Last updated
08/22/2020
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