Organization
EQUI-LIBRIUM THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS R PUTTHOFF (OFFICE ADMINISTRATOR)
(417) 830-1409
Entity
Organization
Contact information
Practice address
1148 S COURTNEY LN, ROGERSVILLE, MO 65742-4501
(417) 830-1409
Mailing address
1148 S COURTNEY LN, ROGERSVILLE, MO 65742-4501
(417) 830-1409
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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