Kristi Lynn Damerval, PTA
Individual provider Active NPI Physical Therapy Assistant · Ottumwa, IA
NPI 1578090429 · NPPES record last updated May 22, 2017
Key facts
- NPI
- 1578090429
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 00843 (IA)
- Practice address
- 3 Pennsylvania PL
Ottumwa, IA 52501-2165 - Phone
- (641) 683-3372
- NPI assigned
- May 22, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 00843 | IA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 00843 | IA | Yes |
Addresses
Primary practice location
3 Pennsylvania PL
Ottumwa, IA 52501-2165
Mailing address
3 Pennsylvania PL
Ottumwa, IA 52501-2165
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All providers in Ottumwa, IA · Physical Therapy Assistant in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2017. 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.