Bonnie Jean Lampe, PTA

Individual provider Active NPI Physical Therapy Assistant · O'Fallon, IL

NPI 1780144808 · NPPES record last updated Mar 24, 2019

Key facts

NPI
1780144808
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
160004212 (IL)
Practice address
316 Donna Dr
O'Fallon, IL 62269
Phone
(618) 660-8686
NPI assigned
Mar 24, 2019
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
160004212ILMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160004212 IL Yes

Addresses

Primary practice location

316 Donna Dr
O'Fallon, IL 62269

Mailing address

316 Donna Dr
O'Fallon, IL 62269
Phone (618) 660-8686

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address bj327@sbcglobal.net

Other providers in O'Fallon, IL

All providers in O'Fallon, IL · Physical Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.