Eichenberger, Gary Dwayne

Eichenberger, Gary Dwayne is an individual health care provider with primary practice located at 102 S Forrest Ave , Liberty MO 64068-1908. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Eichenberger, Gary Dwayne can be contacted via phone (515) 341-2721.

Contact Information

Primary practice address
102 S Forrest Ave Liberty MO 64068-1908
Phone: (515) 341-2721
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 2010031806 Missouri

Profile Details

NPI number 1154610186
LBN Legal business name Eichenberger, Gary Dwayne
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2011
Last updated Jun 13th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154610186 NPPES
Missouri Other 12198273 CAQH NUMBER

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