| |
3999 Hwy Pp, Suite 2, Poplar Bluff, MO 63901 | |
(573) 712-2280 | |
(573) 778-9589 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 3999 Hwy Pp, Poplar Bluff, Missouri |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588848618 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Provider Name | Ryan R Pretz |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1962465658 PECOS PAC ID: 4880668243 Enrollment ID: I20040823000007 |
Provider Name | Antonio Grefal Mauricio |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1992279830 PECOS PAC ID: 3072852185 Enrollment ID: I20190307002600 |
Provider Name | Christopher Lincoln Morse |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1326499351 PECOS PAC ID: 0547686966 Enrollment ID: I20200817001626 |
Mailing Address | Practice Location Address |
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Po Box 3, Poplar Bluff, MO 63902-0003 Ph: (573) 712-2280 | 3999 Hwy Pp, Suite 2, Poplar Bluff, MO 63901 Ph: (573) 712-2280 |