Branden Speckhals
Individual provider Active NPI Physical Therapy Assistant · Hermann, MO
NPI 1124366158 · NPPES record last updated Jan 25, 2013
Key facts
- NPI
- 1124366158
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2012038625 (MO)
- Practice address
- 2347 Highway 100
Hermann, MO 65041-4226 - Phone
- (573) 690-8862
- NPI assigned
- Jan 25, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012038625 | MO | MD | Physical Therapy Assistant |
| 2094108 | TX | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2012038625 | MO | Yes |
| Physical Therapy Assistant | 225200000X | 2094108 | TX |
Addresses
Primary practice location
2347 Highway 100
Hermann, MO 65041-4226
Mailing address
2347 Highway 100
Hermann, MO 65041-4226
Phone (573) 690-8862
Other providers in Hermann, MO
- Rehab Outreach, L.L.C.
- Kathryn Ruhmann
- Amy Marie Sanders
- Joesph Thomas Schebaum
- Angela Dawn Sherrow
- Charles Dennis Steele
- William C. Stief
- Kerry Struttmann
- Donald C Swayze
- Jeremy Shaun Talley
All providers in Hermann, MO · Physical Therapy Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.