Provider Demographics
NPI:1194438762
Name:KILLE, BARBARA ANN (LMT)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:KILLE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1675 E SEMINOLE ST STE H
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-2490
Mailing Address - Country:US
Mailing Address - Phone:417-881-2295
Mailing Address - Fax:417-881-4282
Practice Address - Street 1:1675 E SEMINOLE ST STE H
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2490
Practice Address - Country:US
Practice Address - Phone:417-881-2295
Practice Address - Fax:417-881-4282
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2003026408225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist