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

LicenseStateTypeSpecialty
00843IAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Ottumwa, IA

All providers in Ottumwa, IA · Physical Therapy Assistant in Iowa

Sources for this page

Verify at the official NPI Registry.