Provider Demographics
NPI:1285751834
Name:OWUOR, PERPETUA AKEYO (OT)
Entity type:Individual
Prefix:MS
First Name:PERPETUA
Middle Name:AKEYO
Last Name:OWUOR
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-1851
Mailing Address - Country:US
Mailing Address - Phone:573-760-1053
Mailing Address - Fax:
Practice Address - Street 1:1280 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-2932
Practice Address - Country:US
Practice Address - Phone:573-756-2320
Practice Address - Fax:573-760-8677
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO003471261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO335559OtherHEALTHLINK PROVIDER ID#
MO6400084OtherUHC PROVIDER NUMBER
MO114925OtherBCBS PROVIDER NUMBER
MO6400084OtherUHC PROVIDER NUMBER