Jacqueline Lee Barlow
Individual provider Active NPI Physical Therapy Assistant · Rolla, MO
NPI 1225792013 · NPPES record last updated Oct 27, 2021
Key facts
- NPI
- 1225792013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 1999140711 (MO)
- Practice address
- 11126 Pinedale Dr
Rolla, MO 65401-7912 - Phone
- (314) 619-1206
- NPI assigned
- Oct 27, 2021
- Sex
- Female
- 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 |
|---|---|---|---|
| 1999140711 | MO | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1999140711 | MO | Yes |
Addresses
Primary practice location
11126 Pinedale Dr
Rolla, MO 65401-7912
Mailing address
11126 Pinedale Dr
Rolla, MO 65401-7912
Other providers in Rolla, MO
- Steven R Ballard
- Mahmoud Ballout
- Tasha Baney
- Amanda Christine Banks
- Jennifer Anne Barclay
- Jamie Janece Barlow
- William Mark Barnett
- Caitlyn Micah Barry
- Bartle Chiropractic LLC
- James Jeffrey Bass
All providers in Rolla, 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 Oct 27, 2021. 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.