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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. CLYDE GLENN GORDON DOROMAL, RPT, PTRP

Active Sole Proprietor

MR. CLYDE GLENN GORDON DOROMAL, RPT, PTRP is a Physical Therapy Assistant healthcare provider located in FARMINGTON, Missouri. NPI 1457562357 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · FARMINGTON, MO

Registration Details

NPI Number
1457562357
Provider Type
Individual
Gender
Male
NPI Issued
May 24, 2007 (19.231421819745 yrs)
Last Updated
Jul 8, 2007
License
2006010374 (MO)
Sole Proprietor
Yes

Practice Information

Address
400 MAPLE VALLEY DR
PANG APARTMENT 17
FARMINGTON, MO, 636401973
Browse MO providers · Browse ZIP 63640
Phone
8703291625
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Physical Therapy Assistant

Other Physical Therapy Assistant Providers in FARMINGTON, MO

Name Credential NPI
MRS. CHRISTINE MARIE GEILE PT 1245205236
EDWARD T RINDA PT 1760445464
KENNETH MONROE WILSON MHO PT SCS ATC 1396854915
JOHN BRYAN TEEPE MPT 1801905419
BRANDI NICOLE SCHWARTZ MPT 1134230980
DENA LYNNE ROSE PT 1205947058
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.