Lauren Roxanne Koelling, PT
Individual provider Active NPI Physical Therapist · Cuba, MO
NPI 1689817017 · NPPES record last updated Apr 15, 2009
Key facts
- NPI
- 1689817017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2008036317 (MO)
- Practice address
- 314 E Washington St
Cuba, MO 65453-1831 - Phone
- (573) 667-2030
- Fax
- (573) 677-2033
- NPI assigned
- Apr 15, 2009
- 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 |
|---|---|---|---|
| 2008036317 | MO | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2008036317 | MO | Yes |
Addresses
Primary practice location
314 E Washington St
Cuba, MO 65453-1831
Mailing address
PO Box 291
Rosebud, MO 63091-0291
Phone (573) 694-8396
Other providers in Cuba, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2009. 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.