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General NPI Number Information
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NPI Number | 1699724351
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Entity Type | Individual
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Provider Name | MARIKAY LOU ASBERRY MSPT/ATC
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Gender | Female
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 08/01/2013
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Provider Practice Location Address
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Address Line | 906 N CEDAR ST
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City | ROLLA
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State | MO
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Zip | 65401-3350
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Country | US
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Telephone | 573-338-0999
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Fax | 573-368-2777
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Provider Business Mailing Address
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Address Line | 906 N CEDAR ST
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City | ROLLA
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State | MO
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Zip | 65401-3350
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Country | US
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Telephone | 573-338-0999
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Fax | 573-368-2777
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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 | PT109661
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License Number State | MO
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