| NPI | 1982959011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRET SHERIDAN DERRICK Partner 573-808-2392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MO 2010028179) |
| Additional Taxonomies | 2251E1200X Physical Therapist, Ergonomics (Licence: MO 02148) |
| Enumeration Date | 2012-07-15 |
| Last Update Date | 2012-07-15 |