Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2000157986 | MO |
NPI | 1013116482 |
---|---|
Provider Name | Mrs. Kerry Ann Greil |
First Address | Hillsboro, MO 63050 |
Second Address | Hillsboro, MO 63050 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2007 |
Last Update Date | 22/11/2011 |