Provider Demographics
NPI:1124656574
Name:MAAS, RICHARD DEAN
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DEAN
Last Name:MAAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4254 S MENTOR AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-6684
Mailing Address - Country:US
Mailing Address - Phone:417-730-2012
Mailing Address - Fax:417-730-2119
Practice Address - Street 1:2230 W SUNSET ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5980
Practice Address - Country:US
Practice Address - Phone:417-730-2100
Practice Address - Fax:417-730-2119
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1047532251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic