Mary Bell, PTA

Individual provider Active NPI Physical Therapy Assistant · Columbia, MO

NPI 1144770702 · NPPES record last updated Oct 7, 2016

Key facts

NPI
1144770702
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2012039739 (MO)
Practice address
1100 Club Village Dr
Suite 103
Columbia, MO 65203-4409
Phone
(877) 870-4976
NPI assigned
Oct 7, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2012039739MOMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2012039739 MO Yes

Addresses

Primary practice location

1100 Club Village Dr
Suite 103
Columbia, MO 65203-4409

Mailing address

1100 Club Village Dr
Suite 103
Columbia, MO 65203-4409
Phone (877) 870-4976

Other providers in Columbia, MO

All providers in Columbia, MO · Physical Therapy Assistant in Missouri

Sources for this page

Verify at the official NPI Registry.