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Pedro C Padilla

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NPI Number Detailed Information

Provider Information:

Name: Pedro C Padilla
Gender: M
Provider License Number If Given: 35762

NPI Information:

NPI: 1083608509
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 10/19/2011

Provider Business Mailing Address:

Address: 20 MANOR DR PO BOX 267
Troy, MO 63379
Phone Number: 6365286844
Fax Number: 6364622809

Provider Business Practice Location Address:

Address: 20 MANOR DR
Troy, MO 63379
Phone Number: 6365286844
Fax Number: 6364622809

Provider Taxonomy:

Primary: 208800000X
Secondary (if any):
State: MO

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