| NPI | 1912604281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN POORE Occupational Therapist 573-579-4461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2023-02-07 |
| Last Update Date | 2023-02-07 |