Provider Demographics
NPI:1104240720
Name:NEWTON, CARA (PTA)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:NEWTON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 N BELLE AVE
Mailing Address - Street 2:
Mailing Address - City:BELLE
Mailing Address - State:MO
Mailing Address - Zip Code:65013-3480
Mailing Address - Country:US
Mailing Address - Phone:573-859-3058
Mailing Address - Fax:
Practice Address - Street 1:620 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:MO
Practice Address - Zip Code:65559-1926
Practice Address - Country:US
Practice Address - Phone:573-265-3271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005040400225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant