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NPI Code Detail

MEDICARE: BREA ANNE MASCHING

MEDICARE: BREA ANNE MASCHING
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
1225100000XPhysical Therapist070024533IL

General Provider Information

NPI Number : 1427605450
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREA ANNE MASCHING
Provider Business Mailing Address
First Line : 1154 HEARTHSTONE DR
Second Line :
City : O FALLON
State : IL
Zip : 62269-7044
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1901 FRANK SCOTT PKWY E
Second Line :
City : SHILOH
State : IL
Zip : 62269-7342
Country : US
Telephone Number : 618-624-7077
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2019
Last Update Date : 08/23/2019

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Directions to “ BREA ANNE MASCHING ” Practice Location

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