Healthcare Provider Details
I. General information
NPI: 1306756721
Provider Name (Legal Business Name): PERPETUAL HEALTH LLC DBA SKYN WEIGHT LOSS AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1515 S GLENSTONE AVE
SPRINGFIELD MO
65804-1407
US
IV. Provider business mailing address
1515 S GLENSTONE AVE
SPRINGFIELD MO
65804-1407
US
V. Phone/Fax
- Phone: 417-833-1100
- Fax:
- Phone: 417-833-1100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KIMBERLEE
YASSA
Title or Position: OWNER
Credential: DO
Phone: 427-833-1100