Antonio Mauricio JR., PT

NPI #1992279830 in Poplar Bluff, Missouri

Provider Information

NPI Number: 1992279830
Entity Type: Individual
Name: Antonio Mauricio JR., PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Jan 14, 2019
Last Updated: Mar 30, 2021

Practice Location

Address: 3999 HIGHWAY PP
City: Poplar Bluff
State: Missouri
ZIP Code: 63901-9046
Phone: (573) 712-2280

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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