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Individual

BEVERLY PATTERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA, LMT

Contact information

Practice address
1600 MCPHERSON AVE, COUNCIL BLUFFS, IA 51503-4858
(712) 322-9285
Mailing address
3030 S 133RD ST, OMAHA, NE 68144-3555
(402) 707-2248

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001538
IA
225200000X
Physical Therapy Assistant
179
NE
225700000X
Massage Therapist
1729
NE

Other

Enumeration date
07/16/2011
Last updated
07/16/2011
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