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NPI Code Detail

MEDICARE: HANNAH ISBELL PTA

MEDICARE: HANNAH ISBELL PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant2019040283MO
2225200000XPhysical Therapy Assistant160008642IL

General Provider Information

NPI Number : 1669143194
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH ISBELL PTA
Provider Business Mailing Address
First Line : 14087 BOULDER RD
Second Line :
City : CARLYLE
State : IL
Zip : 62231-4007
Country : US
Telephone Number : 618-610-6220
Fax Number :
Provider Business Practice Location Address
First Line : 111 E ILLINOIS ST
Second Line :
City : NEW BADEN
State : IL
Zip : 62265-1850
Country : US
Telephone Number : 618-588-4924
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2021
Last Update Date : 04/07/2025

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