Basic Information
| Provider Information | |||||||||
| NPI: | 1821205618 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TROSPER | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | KYLE | ||||||||
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| Credential: | PHYSICAL THERAPIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 907 OREGON DR | ||||||||
| Address2: | |||||||||
| City: | CARTERVILLE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 648351047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4174993299 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2727 MC CLELLAND BLVD | ||||||||
| Address2: | |||||||||
| City: | JOPLIN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 648041626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4176252191 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251N0400X | 2006032358 | MO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology |
No ID Information.