Provider Information for 1134143159
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RICHARD PAUL TRAGASZ L.P.C.
Sex: Male
NPI: 1134143159
Last Updated: 2009-09-04
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1134143159 | ||||||||
| Enumeration Date | 2006-07-26 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 189 SAINT JAMES, MO 65559-0189 United States Phone: 573-636-4253 | Fax:573-636-4253 | ||||||||
| Primary Practice Address | 4304 S BEARFIELD RD BOYS AND GIRLS TOWN OF MISSOURI COLUMBIA, MO 65201-9557 United States Phone: 573-874-8686 | Fax:573-874-8608 | ||||||||
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