Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Clyde Glenn Gordon Doromal, RPT, PTRP

Individual provider Physical Therapist · NPI 1457562357

Mr. Clyde Glenn Gordon Doromal, RPT, PTRP is a Physical Therapist in Farmington, Missouri. Practices as a sole proprietor. Licensed in Illinois and Missouri.

Licensed in
IL, MO
In the registry since
2007
Specialties on file
2
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Practice location Address checks out

400 Maple Valley Dr Pang Apt 17
Farmington, MO 63640-1973
Phone: (870) 329-1625
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2006010374 (MO)
Physical Therapist Taxonomy 225100000X (IL)

Record details

NPI number1457562357
Entity typeIndividual (Type 1)
GenderMale
Credentials RPT , PTRP
Sole proprietorYes
NPI enumeratedMay 24, 2007
Last updated in NPPESJuly 8, 2007

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