Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 2007029152 | MO |
NPI | 1225488877 |
---|---|
Provider Name | Teresa Mckerrow |
First Address | Columbia, MO 65201-5844 |
Second Address | Columbia, MO 65201-5844 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2016 |
Last Update Date | 14/06/2016 |