Doctor Name: | MRS. DANA RAYLENE URTON |
NPI Number: | 1114160132 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SOLE PROPRIETOR |
License Number: | |
Business Practice Address: | 204 W Auberry Grv Jamesport, MO - 646487185 |
Business Phone Number: | 6606050042 |
Business Fax Number: | 6606846423 |
Mailing Address: | 204 W Auberry Grv, JAMESPORT |
State: | MO |
Postal Code: | 646487185 |
Phone Number: | 6606050042 |
Fax Number: | 6606846423 |
NPI Enumeration Date: | 04/07/2009 |
NPI Last Update Date: | 04/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1744P3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | Prosthetics Case Management |
Taxonomy Definition: |