Gerry Wade Funkhouser JR., PLPC

NPI #1427567726 in Rolla, Missouri

Provider Information

NPI Number: 1427567726
Entity Type: Individual
Name: Gerry Wade Funkhouser JR., PLPC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Credential: PLPC
Enumeration Date: Sep 29, 2017
Last Updated: Mar 6, 2019

Practice Location

Address: 103 W 10TH ST
City: Rolla
State: Missouri
ZIP Code: 65401
Phone: (833) 338-4673

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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