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Physicians Independent Medical Examiner

Provider NPI: 1134692791

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
300 FLOYD DR  SIKESTON, MO 63801-3960 US
Tel: 573-472-0397  Fax: 573-472-0409

Business Mailing Address:
38 W DAVIS ST  QULIN, MO 63961-8211 US
Tel: 573-429-2190  Fax: --

NPI Information:
NPI: 1134692791
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Independent Medical Examiner
Y224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Occupational Therapy Assistant

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 224Z00000X





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