Individual
LISA FOWLER-KOEPPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1545 E PYTHIAN ST, SPRINGFIELD, MO 65802-2139
(417) 829-0893
(417) 831-7539
Mailing address
1545 E PYTHIAN ST, SPRINGFIELD, MO 65802-2139
(417) 829-0893
(417) 831-7539
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
478109408
—
MO
Enumeration date
11/13/2006
Last updated
07/09/2007
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