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General NPI Number Information
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NPI Number | 1598395691
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Entity Type | Individual
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Provider Name | KELLIE MARIE ASHER DPT
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Gender | Female
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Dates
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Enumeration Date | 01/17/2020
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Last Update Date | 01/17/2020
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Provider Practice Location Address
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Address Line | 1630 RADIO HILL RD
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City | BOONVILLE
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State | MO
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Zip | 65233-1957
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Country | US
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Telephone | 660-882-6584
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Fax |
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Provider Business Mailing Address
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Address Line | 860 COUNTY ROAD 408
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City | HARRISBURG
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State | MO
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Zip | 65256-9601
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Country | US
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Telephone | 660-734-0835
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 2014039414
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License Number State | MO
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