RUSSELL MEDINA GONZALES

JOPLIN, MO
NPI1740490671
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: MO  2005028005)
Enumeration Date2007-05-22
Last Update Date2007-07-08
Business Address
Mr. RUSSELL MEDINA GONZALES PT
214 W 5TH ST STE D-E
JOPLIN, MO 64801-2501
Phone number: 417-782-2917
Mailing Address
Mr. RUSSELL MEDINA GONZALES PT
214 W 5TH ST STE D-E
JOPLIN, MO 64801-2501
Phone number: 417-782-2917
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