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1427567726
GERRY WADE FUNKHOUSER
ROLLA, MO
NPI
1427567726
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: MO 2017034374)
Enumeration Date
2017-09-29
Last Update Date
2019-03-06
Business Address
GERRY WADE FUNKHOUSER PLPC
103 W 10TH ST
ROLLA, MO 65401
Phone number: 833-338-4673
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Mailing Address
GERRY WADE FUNKHOUSER PLPC
1700 ASHWOOD DR APT 7
ROLLA, MO 65401-0102
Phone number: 636-465-4356
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