Healthcare Provider Details
I. General information
NPI: 1326974429
Provider Name (Legal Business Name): PREMIER DRIVING ACADEMY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1389 N CEDARBROOK AVE
SPRINGFIELD MO
65802-6803
US
IV. Provider business mailing address
2373 SHERON DR
NIXA MO
65714-6100
US
V. Phone/Fax
- Phone: 417-890-1043
- Fax:
- Phone: 417-501-4464
- Fax: 866-591-9533
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XR0403X |
| Taxonomy | Driving and Community Mobility Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JAMES
TODD
VERMILLION
Title or Position: OWNER
Credential:
Phone: 417-501-4464