Clyde Glenn Gordon Doromal, RPT, PTRP
NPI 1457562357ActiveIndividual· Physical Therapist· Farmington, MO
Physical Therapist (RPT, PTRP) in Farmington, Missouri, licensed in MO, with an NPI issued in May 2007.
Overview
| NPI | 1457562357 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | RPT, PTRP |
| Sole proprietor | Yes |
| NPI issued | May 24, 2007 |
| Last updated in NPPES | Jul 8, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 2006010374 | MO |
| Physical Therapist | 225100000X | — | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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