Alicia Vestal, PTA

Individual provider Active NPI Physical Therapy Assistant · Unionville, MO

NPI 1629437926 · NPPES record last updated Feb 15, 2016

Key facts

NPI
1629437926
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2008025215 (MO)
Practice address
1926 Oak St
Unionville, MO 63565-1180
Phone
(660) 947-7919
NPI assigned
Feb 15, 2016
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
2008025215MOMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2008025215 MO Yes

Addresses

Primary practice location

1926 Oak St
Unionville, MO 63565-1180

Mailing address

2213 Dewey St
Unionville, MO 63565-1434
Phone (660) 988-0864

Other names

  • Alicia Smith Other name

Other providers in Unionville, MO

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

Sources for this page

Verify at the official NPI Registry.