Crystal Antwiler

Individual provider Active NPI Occupational Therapy Assistant · Neosho, MO

NPI 1215765409 · NPPES record last updated Jul 22, 2024

Key facts

NPI
1215765409
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
2023043658 (MO)
Practice address
1105 Village Rd
Neosho, MO 64850-9076
Phone
(800) 381-0822
NPI assigned
Jul 22, 2024
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
2023043658MOMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2023043658 MO Yes

Addresses

Primary practice location

1105 Village Rd
Neosho, MO 64850-9076

Mailing address

8477 S Suncoast Blvd
Homosassa, FL 34446-5028
Phone (800) 381-0822

Other providers in Neosho, MO

All providers in Neosho, MO · Occupational Therapy Assistant in Missouri

Sources for this page

Verify at the official NPI Registry.