Derek Adelman
Individual provider Active NPI Physical Therapy Assistant · Perryville, MO
NPI 1669801353 · NPPES record last updated Nov 4, 2013
Key facts
- NPI
- 1669801353
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2011021827 (MO)
- Practice address
- 206 Hospital Lane, Ste 100
Perryville, MO 63775 - Phone
- (573) 768-3349
- NPI assigned
- Nov 4, 2013
- Sex
- Male
- 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 |
|---|---|---|---|
| 2011021827 | MO | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2011021827 | MO | Yes |
Addresses
Primary practice location
206 Hospital Lane, Ste 100
Perryville, MO 63775
Mailing address
206 Hospital Lane, Ste 100
Perryville, MO 63775
Other providers in Perryville, MO
- 2Btraumafree LLC
- Julia L Abernathy
- Air Evac EMS Inc.
- Erin Allen
- American Homepatient, Inc.
- Dennis M. Amschler
- Kristin Armbruster
All providers in Perryville, 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 Nov 4, 2013. 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.