Individual
MARY BACHMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
136 TAR C EMBA LN, PERRYVILLE, MO 63775-6187
(573) 547-4405
Mailing address
136 TAR C EMBA LN, PERRYVILLE, MO 63775-6187
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2013038744
MO
Other
Enumeration date
11/22/2013
Last updated
11/22/2013
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