Mid Missouri Physical Therapy

Organization Active NPI Physical Therapist · Macon, MO

NPI 1891908612 · NPPES record last updated Jul 17, 2009

Key facts

NPI
1891908612
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
License
02103 (MO)
Legal business name
MID MISSOURI PHYSICAL THERAPY
Practice address
2005 N. Missouri St.
Suite D
Macon, MO 63552-0381
Phone
(660) 385-6540
Fax
(660) 385-6542
NPI assigned
May 8, 2007
Organization subpart
No

Authorized official

Name
Paul Vincent Lane, P.T.
Title
Ceo
Phone
(660) 385-6540

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

2005 N Missouri St
Ste D
Macon, MO 63552
Phone (660) 385-6540

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225100000X 02103 MO Yes

Addresses

Primary practice location

2005 N. Missouri St.
Suite D
Macon, MO 63552-0381

Mailing address

PO Box 381
Macon, MO 63552-0381
Phone (660) 385-6540

Other providers in Macon, MO

All providers in Macon, MO · Physical Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.