Kristie Ann Haubrich

Individual provider Active NPI Physical Therapy Assistant · Barry, IL

NPI 1851988554 · NPPES record last updated Dec 29, 2020

Key facts

NPI
1851988554
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
160.000484 (IL)
Practice address
1313 Pratt St
Barry, IL 62312-1365
Phone
(217) 335-2326
NPI assigned
Dec 29, 2020
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
160.000484ILMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.000484 IL Yes

Addresses

Primary practice location

1313 Pratt St
Barry, IL 62312-1365

Mailing address

2408 Summer CRK
Quincy, IL 62305-8924
Phone (217) 257-6329

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL kh60625

Other providers in Barry, IL

All providers in Barry, IL · Physical Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.