Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 109692 | MO |
NPI | 1043831381 |
---|---|
Provider Name | Ronald Lee Sapp I |
First Address | Strafford, MO 65757-8279 |
Second Address | Springfield, MO 65807-7310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2020 |
Last Update Date | 28/04/2020 |