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General NPI Number Information
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NPI Number | 1144985888
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Entity Type | Individual
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Provider Name | KEARSTA COURIER
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Gender | Female
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Dates
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Enumeration Date | 11/08/2021
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 3301 BERRYWOOD DR STE 204
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City | COLUMBIA
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State | MO
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Zip | 65201-6517
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Country | US
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Telephone | 217-883-9793
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Fax |
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Provider Business Mailing Address
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Address Line | 500 CEDAR ST
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City | GREENFIELD
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State | IL
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Zip | 62044-1402
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2021044993
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License Number State | MO
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