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Individual

LEANNE MARIE BERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1734 MARKET ST, THERAPY DEPT, HANNIBAL, MO 63401-4025
(573) 629-0321
Mailing address
91 MEADOWS RD, HANNIBAL, MO 63401-2571
(573) 406-5019

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2011034561
MO

Other

Enumeration date
05/24/2012
Last updated
05/24/2012
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