OrganizationActive
Pediatric Place, LLC
NPI 1477304483 · Rehabilitation Practitioner · Clinton, MO
Provider details
- NPI number
- 1477304483
- Entity type
- Organization
- Primary specialty
- Rehabilitation PractitionerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Jessica Schuler, Credentialing Specialist(660) 383-1199
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
210 S 2nd St Ste a
Clinton, MO 64735-2172
Phone: (660) 885-2394
Fax: (660) 383-1650
Approximate (ZIP-level) locationGet directions
Mailing address
210 S 2nd St Ste a
Clinton, MO 64735-2172
Registry dates
- Enumerated
- 2024-03-28
- Last updated
- 2024-03-28
- Certified
- 2024-03-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.