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NPI Code Detail

MEDICARE: CALI INEZ BOESSEN

MEDICARE:   CALI INEZ BOESSEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant2018037318MO

General Provider Information

NPI Number : 1346719176
Entity Type Code : Individual
Provider Name (Legal Business Name) : CALI INEZ BOESSEN
Provider Business Mailing Address
First Line : 616 SPRING HILL LN
Second Line :
City : META
State : MO
Zip : 65058-2025
Country : US
Telephone Number : 573-690-8520
Fax Number :
Provider Business Practice Location Address
First Line : 1720 VIETH DR
Second Line :
City : JEFFERSON CITY
State : MO
Zip : 65109-2056
Country : US
Telephone Number : 573-635-6193
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2018
Last Update Date : 11/22/2018

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Directions to “ CALI INEZ BOESSEN ” Practice Location

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