Provider Demographics
NPI:1083907869
Name:PUPPEL, DARIN THOMAS (LMT)
Entity Type:Individual
Prefix:MR
First Name:DARIN
Middle Name:THOMAS
Last Name:PUPPEL
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2145
Mailing Address - Street 2:
Mailing Address - City:LAKE OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65049-2145
Mailing Address - Country:US
Mailing Address - Phone:573-964-6786
Mailing Address - Fax:573-964-5270
Practice Address - Street 1:121 CROSSINGS W
Practice Address - Street 2:STE F
Practice Address - City:LAKE OZARK
Practice Address - State:MO
Practice Address - Zip Code:65049
Practice Address - Country:US
Practice Address - Phone:573-964-6786
Practice Address - Fax:573-964-5270
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2011012122225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist