Shelby Jennings Sailor, PTA

Individual provider Active NPI Physical Therapy Assistant · Riverside, MO

NPI 1487329231 · NPPES record last updated Oct 12, 2021

Key facts

NPI
1487329231
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2021029779 (MO)
Practice address
220 NW Platte Valley Dr
Riverside, MO 64150-9793
Phone
(816) 741-6374
Fax
(816) 505-3312
NPI assigned
Aug 13, 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

LicenseStateTypeSpecialty
2021029779MOMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2021029779 MO Yes

Addresses

Primary practice location

220 NW Platte Valley Dr
Riverside, MO 64150-9793

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other providers in Riverside, MO

All providers in Riverside, MO · Physical Therapy Assistant in Missouri

Sources for this page

Verify at the official NPI Registry.