| NPI | 1770824062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM RODEGHERO President, Owner 573-822-5731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MO 2006034980) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO 2006034980) |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2014-10-02 |