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General NPI Number Information
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NPI Number | 1538371497
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Entity Type | Individual
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Provider Name | CHRISTOPHER LAWRENCE BILBREY PTA
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Gender | Male
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1000 W. 10TH STREET
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City | ROLLA
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State | MO
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Zip | 65401
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Country | US
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Telephone | 573-458-7889
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Fax |
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Provider Business Mailing Address
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Address Line | 1772 SOUTHRIDGE LANE
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City | OWENSVILLE
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State | MO
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Zip | 65066-2709
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Country | US
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Telephone | 573-437-5374
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2005032727
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License Number State | MO
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