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1104095546
RICHARD PESTILLOS
POPLAR BLUFF, MO
NPI
1104095546
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MO 2006001596)
Enumeration Date
2008-02-28
Last Update Date
2008-02-28
Business Address
RICHARD PESTILLOS PT
3001 MAY ST MARK TWAIN CARING CENTER
POPLAR BLUFF, MO 63901-1942
Phone number: 573-778-0854
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Mailing Address
RICHARD PESTILLOS PT
214 W 5TH ST STE. D&E
JOPLIN, MO 64801-2501
Phone number: 417-782-2917
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