Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | MO |
NPI | 1396344362 |
---|---|
Provider Name | Mr. Richard Hamilton |
First Address | Columbia, MO 65201-5446 |
Second Address | Columbia, MO 65201-5446 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2020 |
Last Update Date | 21/10/2020 |