Mary Bachmann, PTA

Individual provider Active NPI Physical Therapy Assistant · Perryville, MO

NPI 1700216009 · NPPES record last updated Nov 22, 2013

Key facts

NPI
1700216009
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2013038744 (MO)
Practice address
136 Tar C Emba LN
Perryville, MO 63775-6187
Phone
(573) 547-4405
NPI assigned
Nov 22, 2013
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

LicenseStateTypeSpecialty
2013038744MOMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2013038744 MO Yes

Addresses

Primary practice location

136 Tar C Emba LN
Perryville, MO 63775-6187

Mailing address

136 Tar C Emba LN
Perryville, MO 63775-6187

Other providers in Perryville, MO

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

Sources for this page

Verify at the official NPI Registry.