NPI 1265678197

Brock Justin Dodsworth, PTA

Practitioner Physical Therapy Assistant Fort Leonard Wood, MO

Practice location

Address: 4430 Missouri Ave, Fort Leonard Wood, MO 65473-9098
Phone: (573) 596-1707
Mailing address: 14939 Turkey, Saint Robert, MO 65584-3718

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 2007031481 (MO)

Other Physical Therapy Assistant providers in Missouri →

Registry record

NPI: 1265678197
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Dec 2008
Record last updated: 13 Feb 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.