Healthcare Provider Details

I. General information

NPI: 1699798561
Provider Name (Legal Business Name): BDM ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1238 REMINGTON DRIVE
CENTRALIA MO
65240-1197
US

IV. Provider business mailing address

3301 BERRYWOOD DR SUITE 204
COLUMBIA MO
65201-6517
US

V. Phone/Fax

Practice location:
  • Phone: 573-682-2230
  • Fax: 573-682-9580
Mailing address:
  • Phone: 573-449-8771
  • Fax: 573-449-6563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRENDA J REEDER
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 573-449-6082