Tara Renee Dolbeare, PTA

Individual provider Active NPI Physical Therapy Assistant · Pittsfield, IL

NPI 1467091934 · NPPES record last updated Jan 2, 2020

Key facts

NPI
1467091934
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
160.004168 (IL)
Practice address
610 Lowry St
Pittsfield, IL 62363-1768
Phone
(217) 285-5200
NPI assigned
Jan 2, 2020
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
160.004168ILMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.004168 IL Yes

Addresses

Primary practice location

610 Lowry St
Pittsfield, IL 62363-1768

Mailing address

PO Box 302
Pleasant Hill, IL 62366-0302
Phone (217) 242-1457

Other providers in Pittsfield, IL

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

Sources for this page

Verify at the official NPI Registry.