Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251P0200X | Physical Therapist - Pediatrics | 2002019583 | MO |
NPI | 1023175007 |
---|---|
Provider Name | Cindy Marcellino |
First Address | Hillsboro, MO 63050-4313 |
Second Address | Hillsboro, MO 63050-4313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 08/07/2007 |