Cara Lynn Bernaix

Individual provider Active NPI Physical Therapy Assistant · Godfrey, IL

NPI 1336407337 · NPPES record last updated Apr 26, 2012

Key facts

NPI
1336407337
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
160.002908 (IL)
Practice address
1373 Dadrian Professional Park
Godfrey, IL 62035-1767
Phone
(618) 468-8010
NPI assigned
Apr 26, 2012
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
160.002908ILMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.002908 IL Yes

Addresses

Primary practice location

1373 Dadrian Professional Park
Godfrey, IL 62035-1767

Mailing address

2914 N Rodgers Ave
Alton, IL 62002-8846
Phone (618) 410-3391

Other providers in Godfrey, IL

All providers in Godfrey, IL · Physical Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.