Healthcare Provider Details

I. General information

NPI: 1235018359
Provider Name (Legal Business Name): MID-MO MOBILITY PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 9TH ST
TRENTON MO
64683-2207
US

IV. Provider business mailing address

400 E 9TH ST
TRENTON MO
64683-2207
US

V. Phone/Fax

Practice location:
  • Phone: 660-654-2892
  • Fax:
Mailing address:
  • Phone: 660-654-2892
  • Fax:

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: DR. DARYIAN GROSSMAN
Title or Position: DOCTOR OF PHYSICAL THERAPY/OWNER
Credential: DPT
Phone: 660-654-2892