Mariah Walker
Individual provider Active NPI Physical Therapy Assistant · Bernie, MO
NPI 1285207019 · NPPES record last updated Jul 20, 2021
Key facts
- NPI
- 1285207019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2019002757 (MO)
- Practice address
- 117 W Main Ave
Bernie, MO 63822-8501 - Phone
- (810) 610-7315
- NPI assigned
- Jul 20, 2021
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2019002757 | MO | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2019002757 | MO | Yes |
Addresses
Primary practice location
117 W Main Ave
Bernie, MO 63822-8501
Mailing address
PO Box 725
Bernie, MO 63822-0725
Phone (810) 610-7315
Other providers in Bernie, MO
- Southeast Missouri Health Network
- Southeast Missouri Health Network
- Brandi Sparks
- Super D Drugs Acquisition Co.
- Walgreen Co
- Winchester Nursing Center, Inc
- Winchester Place Assisted Living
All providers in Bernie, 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 Jul 20, 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.