Healthcare Provider Details

I. General information

NPI: 1740367747
Provider Name (Legal Business Name): SWEET SPRINGS THERAPY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 BRIDGE STREET
SWEET SPRINGS MO
65351
US

IV. Provider business mailing address

PO BOX 45 718 BRIDGE STREET
SWEET SPRINGS MO
65351
US

V. Phone/Fax

Practice location:
  • Phone: 660-335-4431
  • Fax: 660-335-4134
Mailing address:
  • Phone: 660-335-4431
  • Fax: 660-335-4134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHIRLEY ROMARATE SUMILANG
Title or Position: ADMINISTRATOR
Credential: RPT
Phone: 660-335-4431