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1407107527
EDEFER ANONUEVO DELA CRUZ
SPRINGFIELD, MO
NPI
1407107527
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MO 2006011989)
Enumeration Date
2012-09-28
Last Update Date
2012-09-28
Business Address
Mr. EDEFER ANONUEVO DELA CRUZ RPT
1514 W LARK ST
SPRINGFIELD, MO 65810-2270
Phone number: 417-889-1275
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Mailing Address
Mr. EDEFER ANONUEVO DELA CRUZ RPT
3853 W VINCENT DR
SPRINGFIELD, MO 65810-1061
Phone number: 417-823-7854
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