Raedene Fee, PTA
Individual provider Active NPI Physical Therapy Assistant · Hale, MO
NPI 1497960017 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497960017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 117791 (MO)
- Practice address
- 14069 Highway 139
Hale, MO 64643-8231 - Phone
- (660) 565-2626
- NPI assigned
- May 14, 2007
- 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 |
|---|---|---|---|
| 117791 | MO | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 117791 | MO | Yes |
Addresses
Primary practice location
14069 Highway 139
Hale, MO 64643-8231
Mailing address
14069 Highway 139
Hale, MO 64643-8231
Phone (660) 565-2626
Other providers in Hale, MO
All providers in Hale, 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 8, 2007. 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.