Provider Demographics
NPI:1831446129
Name:SOLE, RICH (LMT)
Entity type:Individual
Prefix:
First Name:RICH
Middle Name:
Last Name:SOLE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 NW HIGHWAY 146
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:64683-7502
Mailing Address - Country:US
Mailing Address - Phone:660-359-1839
Mailing Address - Fax:
Practice Address - Street 1:1009 W SAINT MAARTENS DR
Practice Address - Street 2:STE A
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2963
Practice Address - Country:US
Practice Address - Phone:660-359-1839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003000885225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist